Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | ME98091 | FL |
NPI | 1215940838 |
---|---|
Provider Name | Harold G Bach |
First Address | Boynton Beach, FL 33435-4184 |
Second Address | West Palm Beach, FL 33411 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 27/08/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
150615000 | (05) | MN |
I58467 | (02) |