Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0201X | Internist - Allergy & Immunology | 35.143726 | OH |
Y | 207RA0201X | Internist - Allergy & Immunology | PT18107 | ND |
N | 2080P0201X | Pediatric Allergist | 4301501309 | MI |
NPI | 1316334253 |
---|---|
Provider Name | Jeffrey Kepes |
First Address | Bismarck, ND 58501-4439 |
Second Address | Bismarck, ND 58501-4439 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2015 |
Last Update Date | 14/02/2022 |