Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 35.120914 | OH |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 35.120914 | OH |
NPI | 1275722688 |
---|---|
Provider Name | Rafal Stachowicz |
First Address | Akron, OH 44333-1782 |
Second Address | Akron, OH 44333-1782 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2007 |
Last Update Date | 25/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0081245 | (05) | OH |