Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 27214 | NE |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | BP10032053 | TX |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 27214 | NE |
NPI | 1578714440 |
---|---|
Provider Name | Andrew M Coughlin |
First Address | Virginia Beach, VA 23450-0190 |
Second Address | Omaha, NE 68114-4108 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2008 |
Last Update Date | 24/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100250444-00 | (05) | NE |
10026485711 | (05) | NE |
1578714440 | (05) | IA |