Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 35063522E | OH |
NPI | 1043200074 |
---|---|
Provider Name | William J Esterline |
First Address | Dublin, OH 43016-4259 |
Second Address | Columbus, OH 43213-2174 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2005 |
Last Update Date | 18/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0136650 | (05) | OH |
G00618 | (02) | OH |