Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 137227 | NY |
NPI | 1003901273 |
---|---|
Provider Name | James T Maxwell |
First Address | Rochester, NY 14642-0001 |
Second Address | Rochester, NY 14621-3036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 22/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00684184 | (05) | NY |
B75305 | (02) |