Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 36-00-2819M | OH |
N | 213ES0103X | Foot & Ankle Surgery | PO3344 | FL |
NPI | 1003800525 |
---|---|
Provider Name | Peter H Mason |
First Address | Dayton, OH 45458-6033 |
Second Address | Dayton, OH 45458-6033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2005 |
Last Update Date | 18/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2187888 | (05) | OH |