Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgery, Foot & Ankle |
213ES0103X | 48 | Podiatry | |
Durable Medical Equipment & Medical Supplies |
332B00000X | 54 | Other Medical Supply Company |
| NPI # | 1043730799 |
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| LBN Legal business name | M DOUGLAS SEFCIK DPM LLC | ||||
| Authorized official | MICHAEL SEFCIK - (OWNER) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 06/23/2017 | ||||
| Last updated | 07/21/2022 - About 4 years ago | ||||
| Identifiers |
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