Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | H8332 | TX |
N | 207V00000X | Obstetrician & Gynecologist | MD60330578 | WA |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | H8332 | TX |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD60330578 | WA |
NPI | 1669575163 |
---|---|
Provider Name | Dr. Dwight Scott Poehlmann |
First Address | Federal Way, WA 98003-8727 |
Second Address | Federal Way, WA 98003-8727 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2006 |
Last Update Date | 24/10/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101912704 | (05) | TX |
8B4475 | BCBS OF TEXAS (01) | TX |
F51522 | (02) | TX |