Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | ME69725 | FL |
NPI | 1003812389 |
---|---|
Provider Name | Dr. William Fletcher Drewry JR. |
First Address | Fernandina Beach, FL 32034-5407 |
Second Address | Fernandina Beach, FL 32034-5407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 29/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
271486800 | (05) | FL |