Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | ME90138 | FL |
NPI | 1003854803 |
---|---|
Provider Name | Dr. Sean M Mcwilliams |
First Address | Pensacola, FL 32513-2699 |
Second Address | Destin, FL 32550-7230 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 21/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2700786000 | (05) | FL |
H61774 | (02) | FL |