Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | 348 | AK |
NPI | 1528072535 |
---|---|
Provider Name | Bob E Chaney |
First Address | Anchorage, AK 99508-5925 |
Second Address | Anchorage, AK 99508-5925 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P55439 | (02) | AK |