Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 036143876 | IL |
N | 207X00000X | Orthopaedic Surgeon | 061519 | GA |
N | 207X00000X | Orthopaedic Surgeon | MD60275071 | WA |
NPI | 1013163120 |
---|---|
Provider Name | Dr. Swastik Kumar Sinha |
First Address | O Fallon, IL 62269-1960 |
Second Address | O Fallon, IL 62269-1960 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2008 |
Last Update Date | 11/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036143876 | (05) | IL |