Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 35064486 | OH |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 35064486 | OH |
NPI | 1235107087 |
---|---|
Provider Name | Dr. William A Sanko |
First Address | Lima, OH 45804-4099 |
Second Address | Lima, OH 45804-4099 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 05/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000493151 | ANTHEM (01) | |
0919957 | (05) | OH |
F55990 | (02) |