Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | M13008 | ID |
NPI | 1013179811 |
---|---|
Provider Name | Dr. Patrick William Magajna |
First Address | Coeur D Alene, ID 83814-6051 |
Second Address | Coeur D Alene, ID 83814-6051 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2008 |
Last Update Date | 18/04/2016 |