Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | ME141138 | FL |
Y | 111NI0900X | Internist | ME141138 | FL |
NPI | 1003203142 |
---|---|
Provider Name | Andrei Yerik Hetman |
First Address | Savannah, GA 31404-6220 |
Second Address | Brooksville, FL 34613-5409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2015 |
Last Update Date | 03/08/2021 |