Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | C2-0005154 | DE |
NPI | 1932109097 |
---|---|
Provider Name | Richard Appleby |
First Address | Lewes, DE 19958-1613 |
Second Address | Lewes, DE 19958-1613 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2005 |
Last Update Date | 24/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000864803 | (05) | DE |
G43321 | (02) | DE |