Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 11589 | WV |
NPI | 1003846213 |
---|---|
Provider Name | Dr. Sarah Osorio Loot |
First Address | Oak Hill, WV 25901 |
Second Address | Oak Hill, WV 25901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0110418000 | (05) | WV |
D49430 | (02) |