Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | C1-0007288 | DE |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | C1-0007288 | DE |
N | 207XX0801X | Orthopaedic Trauma Surgeon | C1-0007288 | DE |
NPI | 1083660187 |
---|---|
Provider Name | Joseph J Mesa |
First Address | Newark, DE 19713-2102 |
Second Address | Newark, DE 19713-2102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H47827 | (02) |