Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | A102582 | CA |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 39357 | IA |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD2012-0168 | NM |
NPI | 1528387792 |
---|---|
Provider Name | Nathan Boyd |
First Address | Albuquerque, NM 87106-4374 |
Second Address | Albuquerque, NM 87131-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2010 |
Last Update Date | 22/03/2017 |