Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 01066087A | IN |
N | 111NI0900X | Internist | 01066087A | IN |
Y | 207RN0300X | Nephrologist | 01066087A | IN |
NPI | 1043421209 |
---|---|
Provider Name | Dr. Takashi Hato |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Indianapolis, IN 46202-5149 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2007 |
Last Update Date | 08/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201072400 | (05) | IN |