Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 25020 | WI |
NPI | 1033169917 |
---|---|
Provider Name | Dr. Vijay K Sabnis |
First Address | Onalaska, WI 54650-6758 |
Second Address | Onalaska, WI 54650-6758 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 25/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0970574 | (05) | IA |
1194786350 | (05) | SD |
30479700 | (05) | WI |
326562500 | (05) | MN |
B56237 | (02) |