Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | F1-0000591 | DE |
NPI | 1093850299 |
---|---|
Provider Name | Dr. Raymond Pursell |
First Address | Rehoboth Beach, DE 19971-5562 |
Second Address | Rehoboth Beach, DE 19971-2104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2007 |
Last Update Date | 08/07/2007 |