Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | ME96130 | FL |
Y | 207XS0117X | Orthopaedic Spine Surgeon | ME96130 | FL |
NPI | 1174543573 |
---|---|
Provider Name | Dr. Daniel Shakespeare Husted |
First Address | Stuart, FL 34994-4512 |
Second Address | Stuart, FL 34994-4512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 17/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I40573 | (02) |