Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | A2627A | WY |
NPI | 1124182100 |
---|---|
Provider Name | Dr. Berton James Toews |
First Address | Casper, WY 82609-3764 |
Second Address | Casper, WY 82609-3764 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2006 |
Last Update Date | 16/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1064517000 | (05) | WY |
A72971 | (02) | WY |