Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 38019 | KY |
NPI | 1003860545 |
---|---|
Provider Name | Mr. Sterling A Meza |
First Address | Philpot, KY 42366-9330 |
Second Address | Owensboro, KY 42303-3222 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64063753 | (05) | KY |
H81668 | (02) | KY |