Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 0025 | CO |
NPI | 1124172564 |
---|---|
Provider Name | William E Dwelley |
First Address | Montrose, CO 81401-8754 |
Second Address | Montrose, CO 81401-8754 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 08/07/2007 |