Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 35.129491 | OH |
N | 207RN0300X | Nephrologist | MD08362 | RI |
NPI | 1053358770 |
---|---|
Provider Name | Lance D Dworkin |
First Address | Toledo, OH 43615-4040 |
Second Address | Toledo, OH 43614-2426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 21/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0181612 | (05) | OH |