Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 35060585N | OH |
NPI | 1023017886 |
---|---|
Provider Name | Paul Anthony Nitz |
First Address | Dayton, OH 45420-1143 |
Second Address | Dayton, OH 45420-1143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E17866 | (02) | OH |