Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | MD10572 | RI |
N | 207RI0011X | Interventional Cardiology | MD10572 | RI |
NPI | 1003839218 |
---|---|
Provider Name | Gary M Katzman |
First Address | Providence, RI 02904 |
Second Address | Providence, RI 02904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 12/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7009014 | (05) | RI |
H37743 | (02) |