Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MD00038469 | WA |
N | 207PE0004X | Emergency Medical Services | MD00038469 | WA |
NPI | 1043277783 |
---|---|
Provider Name | Sidney Beers |
First Address | Fox Island, WA 98333-9502 |
Second Address | Auburn, WA 98001-4939 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2006 |
Last Update Date | 29/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8254633 | (05) | WA |
G66070 | (02) | WA |