Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | MC-0445 | ID |
Y | 207RH0003X | Hematology & Oncology | MC-0445 | ID |
N | 207RH0003X | Hematology & Oncology | MD00046391 | WA |
N | 207RX0202X | Medical Oncology | MC-0445 | ID |
NPI | 1124071592 |
---|---|
Provider Name | Dr. Danko Martincic |
First Address | Coeur D Alene, ID 83814-2668 |
Second Address | Coeur D Alene, ID 83814-2668 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 03/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1124071592 | (05) | ID |
I53013 | (02) |