Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | MD60998848 | WA |
NPI | 1083907836 |
---|---|
Provider Name | Dr. Justin Margolis |
First Address | Tacoma, WA 98405 |
Second Address | Stony Brook, NY 11794-8191 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2011 |
Last Update Date | 21/11/2019 |