Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 089355 | OH |
Y | 208600000X | Surgeon | 089355 | OH |
NPI | 1013989482 |
---|---|
Provider Name | Dr. Michael Joseph Mulcahy |
First Address | Tacoma, WA 98402-3297 |
Second Address | Tacoma, WA 98431-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
338330 | (02) | WA |
35.089355 | LICENSE (01) | OH |