Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 45892 | CO |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 45892 | CO |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 45892 | CO |
NPI | 1366540072 |
---|---|
Provider Name | Dhruv B Pateder |
First Address | Reston, VA 20190-5896 |
Second Address | Reston, VA 20190-5896 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 31/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0101243633 | VIRGINIA LICENSE (01) | VA |