Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | DE60912789 | WA |
N | 1223G0001X | General Practice | DE60912789 | WA |
N | 213EG0000X | General Practice | DE60912789 | WA |
NPI | 1891265807 |
---|---|
Provider Name | Adam Kutzner |
First Address | San Antonio, TX 78232 |
Second Address | San Antonio, TX 78232 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2018 |
Last Update Date | 30/12/2021 |