Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 01064725A | IN |
Y | 207X00000X | Orthopaedic Surgeon | 35048926 | OH |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 28915 | OK |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | 35048926 | OH |
NPI | 1346274875 |
---|---|
Provider Name | Diane E Vonstein |
First Address | Upper Sandusky, OH 43351-1098 |
Second Address | Upper Sandusky, OH 43351-1098 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 20/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000550234 | ANTHEM PROVIDER NUMBER (01) | IN |
0559766 | (05) | OH |
200372360 | (05) | IN |
A16465 | (02) | IN |