Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | ME72199 | FL |
NPI | 1003822255 |
---|---|
Provider Name | Dr. Stephen Ekman |
First Address | New Port Richey, FL 34655-2106 |
Second Address | Safety Harbor, FL 34695 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F16990 | (02) |