Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 9945 | WV |
NPI | 1003948712 |
---|---|
Provider Name | Donald Edward Farmer |
First Address | Charleston, WV 25304-3100 |
Second Address | Charleston, WV 25304-3100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0070044000 | (05) | WV |
A71880 | (02) |