Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 11337 | OK |
Y | 111NI0900X | Internist | 11337 | OK |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 11337 | OK |
NPI | 1013901461 |
---|---|
Provider Name | Daniel Dean Washburn |
First Address | Malvern, PA 19355-0746 |
Second Address | Enid, OK 73701-5952 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2005 |
Last Update Date | 19/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100253320D | (05) | OK |
D35385 | (02) | OK |
P01284450 | RR MEDICARE (01) | OK |