Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 14011 | MS |
NPI | 1003850009 |
---|---|
Provider Name | Stanko Vuk |
First Address | Lafayette, LA 70508-3870 |
Second Address | Houston, MS 38851 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 29/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00115358 | (05) | MS |
F21839 | (02) | MS |