Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 036138675 | IL |
NPI | 1265660534 |
---|---|
Provider Name | Debdut Biswas |
First Address | Warrenville, IL 60555-3846 |
Second Address | Warrenville, IL 60555-3846 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2009 |
Last Update Date | 23/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036138675 | PHYSICIAN AND SURGEON LICENSE (01) | IL |