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Individual
JONATHAN EKEDAHL
Active
Individual
JONATHAN EKEDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
D74366
MD
390200000X
Student in an Organized Health Care Education/Training Program
0116021210
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
05/30/2008
Last updated
10/04/2012
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