Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | OP00001169 | WA |
N | 111NI0900X | Internist | OP00001169 | WA |
N | 207RC0200X | Critical Care Medicine | OP00001169 | WA |
Y | 207RP1001X | Pulmonary Disease | OP00001169 | WA |
NPI | 1003853227 |
---|---|
Provider Name | Samuel Greg Joseph |
First Address | Spokane, WA 99204-4800 |
Second Address | Spokane, WA 99204-4800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2006 |
Last Update Date | 18/04/2012 |