Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 0103000588 | VA |
Y | 222Z00000X | Podiatrist | 0103000588 | VA |
NPI | 1063471258 |
---|---|
Provider Name | Dr. Ayne F Furman |
First Address | Alexandria, VA 22314 |
Second Address | Alexandria, VA 22314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 12/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T31027 | (02) |