Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 0101262112 | VA |
N | 208200000X | Surgeon | 113000041 | IL |
N | 208600000X | Surgeon | 113000041 | IL |
NPI | 1114955028 |
---|---|
Provider Name | Josef Oberholzer |
First Address | Charlottesville, VA 22906-9007 |
Second Address | Charlottesville, VA 22908-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 21/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I00470 | (02) | IL |