Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 47796 | MN |
Y | 2080P0202X | Pediatric Cardiologist | 47796 | MN |
NPI | 1073593877 |
---|---|
Provider Name | Nathaniel W Taggart |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2006 |
Last Update Date | 27/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I36049 | (02) |