Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0127X | Trauma Surgeon | 20A9509 | CA |
NPI | 1164610523 |
---|---|
Provider Name | Dr. Anthony Shiflett |
First Address | Washington, DC 20010-2975 |
Second Address | Washington, DC 20010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2007 |
Last Update Date | 27/11/2018 |