Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 57.010257 | OH |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | MD.204613 | LA |
NPI | 1316157449 |
---|---|
Provider Name | Sean Robert Waldron |
First Address | New Orleans, LA 70121-2429 |
Second Address | New Orleans, LA 70121-2429 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 03/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
09458516 | (05) | MS |
2159739 | (05) | LA |