Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 123669 | OH |
N | 111NI0900X | Internist | 123669 | OH |
N | 207RH0000X | Hematologist | 14498 | ND |
Y | 207RH0003X | Hematology & Oncology | MD61116309 | WA |
N | 207RX0202X | Medical Oncology | 14498 | ND |
NPI | 1093093619 |
---|---|
Provider Name | Dr. Madhu Unnikrishnan |
First Address | Liberty Lake, WA 99019-0421 |
Second Address | Spokane, WA 99208-6290 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2011 |
Last Update Date | 05/06/2021 |