Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | M6585 | ID |
NPI | 1164507166 |
---|---|
Provider Name | Dr. John A Sturges |
First Address | Coeur D Alene, ID 83814-2606 |
Second Address | Coeur D Alene, ID 83814-2606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2006 |
Last Update Date | 18/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003941500 | (05) | ID |
E47919 | (02) | ID |