Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 1686 | OH |
Y | 222Z00000X | Podiatrist | 1686 | OH |
NPI | 1053463117 |
---|---|
Provider Name | Dr. Raymond Randall Alferink |
First Address | Fairview Park, OH 44126-3340 |
Second Address | Fairview Park, OH 44126-3340 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0487727 | (05) | OH |
T95755 | (02) | OH |