Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | MD00027644 | WA |
NPI | 1134202260 |
---|---|
Provider Name | Dr. Andrew James Holman |
First Address | Renton, WA 98055-6238 |
Second Address | Renton, WA 98055 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F28018 | (02) | WA |