Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 338 | AZ |
Y | 222Z00000X | Podiatrist | 338 | AZ |
NPI | 1063460038 |
---|---|
Provider Name | Dr. William Joseph Accomando |
First Address | Scottsdale, AZ 85260 |
Second Address | Scottsdale, AZ 85260 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2006 |
Last Update Date | 16/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
AZ0193360 | BC (01) | |
U23967 | (02) |