Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223D0001X | Dental Public Health | DN08637 | FL |
Y | 1223G0001X | General Practice | DN8637 | FL |
Y | 213EG0000X | General Practice | DN8637 | FL |
NPI | 1598871758 |
---|---|
Provider Name | Dr. Douglas G Woersching |
First Address | West Palm Beach, FL 33401-5107 |
Second Address | Riviera Beach, FL 33404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 24/10/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
070494600 | (05) | FL |