Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 9723 | SC |
N | 1223D0004X | Dentist Anesthesiologist | DA022458A | PA |
NPI | 1063455921 |
---|---|
Provider Name | Dr. Walter P. Laverick |
First Address | Pittsburgh, PA 15220-3510 |
Second Address | Pittsburgh, PA 15220-3510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 13/04/2021 |