Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 46446 | AZ |
NPI | 1275705188 |
---|---|
Provider Name | Dr. Atanu Biswas |
First Address | Peoria, AZ 85381-4817 |
Second Address | Peoria, AZ 85381-4817 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2008 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13588740 | CAQH (01) | |
1982087441 | GROUP NPI (01) |