Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 35132100 | OH |
N | 207RH0003X | Hematology & Oncology | 9511470-1205 | UT |
Y | 207RX0202X | Medical Oncology | 35132100 | OH |
N | 207RX0202X | Medical Oncology | 9511470-1205 | UT |
NPI | 1083677413 |
---|---|
Provider Name | Edgar Friedrich Prasthofer |
First Address | Salt Lake City, UT 84103-4216 |
Second Address | Durango, CO 81301-7306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2006 |
Last Update Date | 10/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0237183 | (05) | OH |
C73921 | (02) | CO |