Individual
MR. WINTHROP S RISK II
Active
Individual
MR. WINTHROP S RISK II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
35883
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0450387
—
IA
01
—
38919
WELLMARK
IA
01
—
IA0111
HERITAGE
IA
Enumeration date
01/01/2006
Last updated
04/20/2012
Update your record
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