Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | MD00028782 | WA |
NPI | 1033297171 |
---|---|
Provider Name | Michael M Barsotti |
First Address | Vancouver, WA 98668-1600 |
Second Address | Vancouver, WA 98664-3200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2006 |
Last Update Date | 27/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1327907 | (05) | WA |
D20540 | (02) |