Individual
MR. IAN WEST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
20621
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102255320
ACS/DOL PROVIDER #
MD
01
—
290981
MAMSI PROVIDER NUMBER
MD
01
—
4761-0175
CAREFIRST BLUE CHOICE
MD
01
—
616428
BCBS OF MD PROVIDER #
MD
01
—
61671003
CAREFIRST BCBS PROVIDER #
MD
01
—
PT20621
PT LICENSE NUMBER
MD
Enumeration date
07/27/2006
Last updated
11/17/2022
Update your record
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