Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | MD60152986 | WA |
N | 208000000X | Pediatrician | 036-099156 | IL |
N | 2084N0402X | Child Neurologist | MD60152986 | WA |
NPI | 1538282736 |
---|---|
Provider Name | William Brian Dobyns |
First Address | Seattle, WA 98145-5003 |
Second Address | Chicago, IL 60637-1447 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2007 |
Last Update Date | 20/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036099156 | (05) | IL |
B52455 | (02) | IL |