Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | ME86972 | FL |
NPI | 1407861859 |
---|---|
Provider Name | T Christopher Windham |
First Address | Orlando, FL 32891-7770 |
Second Address | Tampa, FL 33612-9416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 05/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
268916200 | (05) | FL |
37611 | BLUE CROSS BLUE SHIELD (01) | FL |
G56465 | (02) | FL |