Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | ME88805 | FL |
NPI | 1568579274 |
---|---|
Provider Name | Soumendu K Das |
First Address | Peoria, AZ 85345-4120 |
Second Address | Scottsdale, AZ 85251 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 01/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
268514100 | (05) | FL |
G43841 | (02) | FL |