Individual
DOUGLAS J WINJUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
20719
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0521021
—
IA
05
—
100313450A
—
KS
01
—
300086696
RR MEDICARE
NE
01
—
32295
BLUE CROSS BLUE SHIELD
NE
05
—
7783110
—
SD
Enumeration date
05/20/2006
Last updated
10/19/2011
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