Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | ME 71404 | FL |
NPI | 1669478038 |
---|---|
Provider Name | Dr. Pierre Girard |
First Address | Port St Lucie, FL 34984-5141 |
Second Address | Port St Lucie, FL 34984-5141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 19/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1922812 | UNITED HEALTH CARE (01) | FL |
250836200 | (05) | FL |
3830923 | CIGNA (01) | FL |
5172688 | AETNA (01) | FL |
G32524 | (02) | FL |