Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 128338 | OH |
N | 207W00000X | Ophthalmologist | 15241 | CA |
Y | 207W00000X | Ophthalmologist | 17065 | NV |
NPI | 1033473913 |
---|---|
Provider Name | Dr. Michael Derek Westafer |
First Address | Henderson, NV 89012-5731 |
Second Address | Carson City, NV 89703-8462 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2012 |
Last Update Date | 26/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1033473913 | (05) | NV |