Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | A81041 | CA |
Y | 207T00000X | Neurosurgeon | MD60218165 | WA |
NPI | 1114196466 |
---|---|
Provider Name | Dr. Allan Christopher Heller |
First Address | Spokane, WA 99220-3649 |
Second Address | Spokane, WA 99204-2823 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2008 |
Last Update Date | 03/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2013414 | (05) | WA |