Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 14159 | MS |
NPI | 1013098995 |
---|---|
Provider Name | Avinash C Gulanikar |
First Address | Flowood, MS 39232 |
Second Address | Flowood, MS 39232 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 02/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00120500 | (05) | MS |