Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 61997-20 | WI |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 61997-20 | WI |
NPI | 1114946589 |
---|---|
Provider Name | Dr. Arthur Charles Coffey |
First Address | Delafield, WI 53018-1452 |
Second Address | Delafield, WI 53018-1452 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 03/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200217230 | (05) | IN |