Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 97140 | NM |
NPI | 1144217563 |
---|---|
Provider Name | Robert W Seaton |
First Address | Las Cruces, NM 88011-8259 |
Second Address | Las Cruces, NM 88011-8259 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2005 |
Last Update Date | 27/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B02123 | (02) |