Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 35.141901 | OH |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | M9371 | ID |
NPI | 1639121098 |
---|---|
Provider Name | Robert Alan Ancker |
First Address | Cleveland, OH 44110-2602 |
Second Address | Cleveland, OH 44110-2602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 15/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E84565 | (02) | ID |