Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 038006296 | IL |
NPI | 1477597565 |
---|---|
Provider Name | Dr. David Eric Bemis |
First Address | Alton, IL 62002-6232 |
Second Address | Alton, IL 62002-6232 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 19/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
038006296 | (05) | IL |
T87125 | (02) | IL |