Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD60962560 | WA |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD60962560 | WA |
NPI | 1174865224 |
---|---|
Provider Name | Adam P. Sangeorzan |
First Address | Seattle, WA 98122-5330 |
Second Address | Seattle, WA 98122 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2013 |
Last Update Date | 01/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2028849 | (05) | WA |