Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 19316 | KY |
NPI | 1033298641 |
---|---|
Provider Name | Dr. Bonifacio Aranas |
First Address | Warfield, KY 41267-0303 |
Second Address | Warfield, KY 41267 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000046984 | BLUE CROSS/BLUE SHEILD (01) | KY |
0049101000 | (05) | WV |
64193162 | (05) | KY |
C69555 | (02) | KY |