Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 20342 | MS |
N | 2086S0120X | Pediatric Surgery | D0062695 | MD |
NPI | 1598818437 |
---|---|
Provider Name | Dr. David Emile Sawaya JR. |
First Address | Jackson, MS 39216-4500 |
Second Address | Jackson, MS 39216-4500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 16/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02208220 | (05) | MS |
151421 | (05) | MS |