Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MD00039977 | WA |
NPI | 1053382671 |
---|---|
Provider Name | Dr. Barry Jay Landau |
First Address | Bellingham, WA 98225-1720 |
Second Address | Bellingham, WA 98225-1720 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2006 |
Last Update Date | 26/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8278863 | (05) | WA |
F48710 | (02) |