Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | C10009481 | DE |
N | 207XP3100X | Pediatric Orthopaedic Surgeon | C7-0004213 | DE |
NPI | 1255597407 |
---|---|
Provider Name | Dr. Alfred Wahabi Atanda JR. |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2008 |
Last Update Date | 07/10/2011 |