Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 5710A | WY |
N | 207YS0123X | Facial Plastic Surgeon | 5710A | WY |
NPI | 1922184647 |
---|---|
Provider Name | Dr. Scott N Bateman |
First Address | Sheridan, WY 82801-3829 |
Second Address | Sheridan, WY 82801-3829 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 13/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
116034100 | (05) | WY |
303780 | BLUECROSS BLUESHIELD (01) | WY |
G04694 | (02) |