Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 034256 | GA |
NPI | 1003800103 |
---|---|
Provider Name | Dr. Michael Walter Szpak |
First Address | Albany, GA 31701-1970 |
Second Address | Albany, GA 31701-1903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2005 |
Last Update Date | 30/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A79984 | (02) | GA |