Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | M7348 | ID |
N | 207V00000X | Obstetrician & Gynecologist | MD000333237 | WA |
NPI | 1013090836 |
---|---|
Provider Name | Sean T Urquhart |
First Address | Lewiston, ID 83501-7301 |
Second Address | Lewiston, ID 83501-7301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 07/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0170479 | WA LABOR & INDUSTRIES (01) | WA |
1000326 | (05) | WA |
1013090836 | (05) | ID |
1013090836 | REGENCE BLUESHIELD (01) | ID |
53744 | BLUE CROSS (01) | ID |
G18235 | (02) | ID |