Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 50164 | KY |
N | 207P00000X | Emergency Physician | MD172014 | OR |
N | 207RA0401X | Internist - Addiction Medicine | 50164 | KY |
NPI | 1528320652 |
---|---|
Provider Name | Dr. Peter Damian Storey Akpunonu |
First Address | Lexington, KY 40536 |
Second Address | Lexington, KY 40536-3011 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2012 |
Last Update Date | 05/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1528320652 | (05) | ID |
1528320652 | (05) | KY |
1528320652 | (05) | WA |
1528320652 | (05) | WV |
500688288 | (05) | OR |
Q03304 | (05) | TN |