Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 01084252A | IN |
Y | 208600000X | Surgeon | 01084252A | IN |
N | 2086S0105X | Surgery of the Hand | 65417 | MN |
NPI | 1639514011 |
---|---|
Provider Name | Anthony Joseph Archual |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Rochester, MN 55905-0002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2013 |
Last Update Date | 03/12/2021 |