Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 0101238298 | VA |
NPI | 1124009667 |
---|---|
Provider Name | Dr. William Sukovich |
First Address | Charlottesville, VA 22911-8835 |
Second Address | Charlottesville, VA 22911-8835 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2005 |
Last Update Date | 22/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010240573 | (05) | VA |
10003995 | (05) | VA |
10003995 | COMMUNITY HEALTH (01) | VA |
1219881 | CIGNA (01) | VA |
188897 | (05) | VA |
188897 | ANTHEM/HEALTHKEEPERS (01) | VA |
415564 | SOUTHERN HEALTH (01) | VA |
738220 | MAMSI (01) | VA |
I50138 | (02) | |
P00285406 | MEDICARE PIN (01) | VA |
P00285406 | RAILROAD MEDICARE (01) | VA |