Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | ME75428 | FL |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME75428 | FL |
NPI | 1023013737 |
---|---|
Provider Name | George John Haidukewych |
First Address | Orlando, FL 32806-2028 |
Second Address | Orlando, FL 32806-2028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2005 |
Last Update Date | 09/02/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
268409800 | (05) | FL |
2915522 | AVMED (01) | FL |
5211045 | AETNA (01) | FL |
8164744 | CIGNA (01) | FL |
82052 | BCBS OF FL (01) | FL |
F86388 | (02) | FL |
P00201358 | RAILROAD MEDICARE (01) | FL |