Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | MD60072206 | WA |
Y | 2081S0010X | Sports Medicine | 60072206 | WA |
Y | 213ES0000X | Sports Medicine | 60072206 | WA |
NPI | 1356454003 |
---|---|
Provider Name | Dr. Michael Kwame Turner |
First Address | West Richland, WA 99353 |
Second Address | Kennewick, WA 99336-1355 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 02/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0255541 | DEPT LABOR & INDUSTRIES (01) | WA |
8544710 | (05) | WA |
MD60072206 | STATE LICENSE (01) | WA |