Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | AT006122 | OH |
NPI | 1093323057 |
---|---|
Provider Name | Adam Feinberg |
First Address | Youngstown, OH 44555-0001 |
Second Address | Youngstown, OH 44555-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2020 |
Last Update Date | 16/07/2020 |