Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | TP573 | KY |
NPI | 1033348768 |
---|---|
Provider Name | Raymond Elsoueidi |
First Address | Hazard, KY 41701-9466 |
Second Address | Hazard, KY 41701-9466 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2009 |
Last Update Date | 02/07/2009 |