Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 4934 | SD |
NPI | 1083700512 |
---|---|
Provider Name | James F Nabwangu |
First Address | Rapid City, SD 57709-3450 |
Second Address | Rapid City, SD 57701-6003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 03/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6100783 | (05) | SD |