Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD00043981 | WA |
N | 111NI0900X | Internist | MD00043981 | WA |
Y | 207SG0201X | Clinical Genetics (M.D.) | 44315 | MN |
N | 207SG0201X | Clinical Genetics (M.D.) | MD00043981 | WA |
N | 208000000X | Pediatrician | 44315 | MN |
N | 208000000X | Pediatrician | MD00043981 | WA |
NPI | 1528187846 |
---|---|
Provider Name | Dr. David Roger Deyle |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 13/08/2020 |