Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | 24750 | MN |
NPI | 1023039377 |
---|---|
Provider Name | Dr. George Nicholas Battis JR. |
First Address | Saint Paul, MN 55101-2037 |
Second Address | Saint Paul, MN 55101-2037 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2006 |
Last Update Date | 30/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A93847 | (02) | MN |