Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | D0024402 | MD |
Y | 207XS0106X | Orthopaedic Hand Surgeon | MD27559 | OR |
NPI | 1225191257 |
---|---|
Provider Name | Dr. William L Vetter |
First Address | Portland, OR 97232-2023 |
Second Address | Portland, OR 97232-2023 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2006 |
Last Update Date | 07/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A48514 | (02) |