Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD00023733 | WA |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | MD00023733 | WA |
NPI | 1245314970 |
---|---|
Provider Name | Dr. Bruce Joseph Sangeorzan |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98104-2420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 27/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0231815 | L&I (01) | WA |
1245314970 | (05) | WA |
200012199 | RAIL ROAD MEDICARE (01) | WA |
A06087 | (02) |