Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 28330301 | NY |
NPI | 1003890948 |
---|---|
Provider Name | William Baumgratz |
First Address | Jamestown, NY 14701-7077 |
Second Address | Jamestown, NY 14701-7077 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2005 |
Last Update Date | 15/06/2021 |