Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 066 | SC |
NPI | 1144289802 |
---|---|
Provider Name | Donald R Alkema |
First Address | Mauldin, SC 29662-0791 |
Second Address | Mauldin, SC 29662-2626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T24985 | (02) |