Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 26976 | NE |
N | 207X00000X | Orthopaedic Surgeon | TP814 | KY |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 278065 | MA |
NPI | 1386943777 |
---|---|
Provider Name | Dr. Joseph Henry Dannenbaum IV |
First Address | Tacoma, WA 98431-0001 |
Second Address | Tacoma, WA 98431-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2011 |
Last Update Date | 06/05/2021 |