Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 2594 | NV |
NPI | 1063478410 |
---|---|
Provider Name | Mr. James Bruce Atcheson |
First Address | Reno, NV 89502-2055 |
Second Address | Reno, NV 89521-5860 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 01/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1063478410 | (05) | NV |
11050619 | CAQH (01) | |
D94344 | (02) | NV |