Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 25MA06602900 | NJ |
NPI | 1013902477 |
---|---|
Provider Name | David Egger Powell |
First Address | Boston, MA 02241-6457 |
Second Address | Springfield, NJ 07081-2221 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2005 |
Last Update Date | 09/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7395205 | (05) | NJ |
G56138 | (02) |