Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME80418 | FL |
N | 111NI0900X | Internist | ME80418 | FL |
Y | 207RC0200X | Critical Care Medicine | ME80418 | FL |
N | 207RP1001X | Pulmonary Disease | ME80418 | FL |
NPI | 1023063591 |
---|---|
Provider Name | Dr. Jeremy Michael Segal |
First Address | West Palm Beach, FL 33410 |
Second Address | West Palm Beach, FL 33410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 07/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ME80418 | LICENSE (01) | FL |
VAD000 | (02) |