Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | MD00038407 | WA |
NPI | 1013913938 |
---|---|
Provider Name | Anthony Paul Caruso |
First Address | Federal Way, WA 98003-8723 |
Second Address | Federal Way, WA 98003-8723 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 28/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1427128198 | GROUP NPI (01) | WA |
7125081 | (05) | WA |
H17369 | (02) |