Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 0103300871 | VA |
NPI | 1295703734 |
---|---|
Provider Name | Michael Christopher Donato |
First Address | Fredericksburg, VA 22404-8389 |
Second Address | Fredericksburg, VA 22408-1930 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2006 |
Last Update Date | 09/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010082056 | (05) | VA |
U90649 | (02) | VA |