Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0210X | Pediatric Nephrologist | 01057659 | IN |
Y | 2080P0210X | Pediatric Nephrologist | 40567 | AZ |
NPI | 1619085776 |
---|---|
Provider Name | Mr. Emmanuel Lamug Apostol |
First Address | Tucson, AZ 85756-7124 |
Second Address | Tucson, AZ 85711 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 22/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
145590G4 | (02) | |
200441120 | (05) | IN |
F42202 | (02) |