Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | MD00268600 | NJ |
NPI | 1043439599 |
---|---|
Provider Name | Dr. Douglas Stuart Lynch |
First Address | Freehold, NJ 07728-1328 |
Second Address | Freehold, NJ 07728-1328 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2007 |
Last Update Date | 27/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U91529 | (02) | NJ |