Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 170100000X | Medical Geneticist | 14904 | AZ |
Y | 207V00000X | Obstetrician & Gynecologist | 14904 | AZ |
NPI | 1134111941 |
---|---|
Provider Name | Dr. Gwynn Rawding Patterson |
First Address | Sierra Vista, AZ 85635-2494 |
Second Address | Sierra Vista, AZ 85635-2494 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2005 |
Last Update Date | 08/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2700348002 | (05) | AZ |
270348002 | (05) | AZ |
D37424 | (02) | AZ |