Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0201X | Internist - Allergy & Immunology | 20878 | AL |
Y | 207RA0201X | Internist - Allergy & Immunology | ME0076685 | FL |
NPI | 1891776563 |
---|---|
Provider Name | Dr. Stephen H Kimura |
First Address | Pensacola, FL 32514-6049 |
Second Address | Pensacola, FL 32504-9075 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2005 |
Last Update Date | 18/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F36505 | (02) |