Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | M000896 | GU |
NPI | 1033297403 |
---|---|
Provider Name | Dr. James Vinnie Mcdarby |
First Address | Tamuning, GU 96913 |
Second Address | Tamuning, GU 96913 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F88470 | (02) |