Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 73557 | GA |
N | 207X00000X | Orthopaedic Surgeon | MD36474 | AL |
N | 207X00000X | Orthopaedic Surgeon | ME139069 | FL |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 73557 | GA |
NPI | 1831154723 |
---|---|
Provider Name | David P Antekeier |
First Address | Fortson, GA 31808-0370 |
Second Address | Columbus, GA 31909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 11/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H31661 | (02) | KY |