Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 4252 | NE |
NPI | 1144291469 |
---|---|
Provider Name | Dr. Steven Robert Hinze |
First Address | North Platte, NE 69101-6079 |
Second Address | North Platte, NE 69101-6079 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
470632516-00 | (05) | NE |
T77035 | (02) | NE |