Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 00027282 | AL |
NPI | 1003833021 |
---|---|
Provider Name | Robert E Ostendorf III |
First Address | Gadsden, AL 35903-1102 |
Second Address | Gadsden, AL 35903-1102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 20/02/2015 |