Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 1810 | WV |
NPI | 1770631293 |
---|---|
Provider Name | Dr. Donald W Steere |
First Address | Glen Dale, WV 26038-1646 |
Second Address | Glen Dale, WV 26038-1646 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1810 | STATE LIC NUMBER (01) | WV |