Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | POD000655 | GA |
NPI | 1063560639 |
---|---|
Provider Name | Dr. William A Solomon |
First Address | College Park, GA 30349-4330 |
Second Address | College Park, GA 30349-4330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T34336 | (02) | GA |