Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | MD00023924 | WA |
NPI | 1023005907 |
---|---|
Provider Name | Michael F. Kestell |
First Address | Spokane, WA 99204-2302 |
Second Address | Spokane, WA 99204-2302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8007478 | (05) | WA |
A06387 | (02) |