Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 030922 | GA |
NPI | 1033109079 |
---|---|
Provider Name | Dr. Steven B. Wertheim |
First Address | Atlanta, GA 30342-5000 |
Second Address | Atlanta, GA 30342-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2005 |
Last Update Date | 31/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B37175 | (02) | GA |