Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 5568 | AZ |
NPI | 1679801526 |
---|---|
Provider Name | Dr. Richard Besserman |
First Address | Phoenix, AZ 85016 |
Second Address | Phoenix, AZ 85016-4502 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2009 |
Last Update Date | 03/12/2009 |