Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | 4573 | TX |
Y | 213ER0200X | Radiology | 4573 | TX |
NPI | 1700840246 |
---|---|
Provider Name | Dr. George Brian Batenchuk |
First Address | Sylvania, OH 43560-3229 |
Second Address | Toledo, OH 43612-4548 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U16382 | (02) | TX |