Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 7415 | NV |
N | 207XS0117X | Orthopaedic Spine Surgeon | 7415 | NV |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 7415 | NV |
NPI | 1093767089 |
---|---|
Provider Name | Mr. Digby Maxwell Preston |
First Address | Reno, NV 89502-8410 |
Second Address | Reno, NV 89502-8410 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 23/10/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002016551 | (05) | NV |
G01685 | (02) | NV |