Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD 2962 | DC |
N | 111NI0900X | Internist | MD 2962 | DC |
N | 207RR0500X | Rheumatology | MD 2962 | DC |
NPI | 1093715005 |
---|---|
Provider Name | Dr. Kenneth Ian Austin |
First Address | Washington, DC 20015-1266 |
Second Address | Washington, DC 20017-2151 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C 88210 | (02) |