Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 018342 | GA |
NPI | 1134131642 |
---|---|
Provider Name | Erlinda Valdecanas |
First Address | Milledgeville, GA 31062-7525 |
Second Address | Milledgeville, GA 31062-7525 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00194455B | (05) | GA |
D31077 | (02) | GA |