Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 193454 | NY |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 193454 | NY |
NPI | 1003820630 |
---|---|
Provider Name | Dr. Shevaun Mackie Doyle |
First Address | New York, NY 10087-9234 |
Second Address | New York, NY 10021-4823 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 18/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01824033 | (05) | NY |
G68750 | (02) | NY |