Individual
DIRK ENTZIAN
Active
Individual
DIRK ENTZIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
050160
GA
2085R0202X
Diagnostic Radiology Physician
8048800-1205
UT
2085R0202X
Diagnostic Radiology Physician
M-11566
ID
2085R0202X
Diagnostic Radiology Physician
Primary
ME126598
FL
2085R0204X
Vascular & Interventional Radiology Physician
050160
GA
2085R0204X
Vascular & Interventional Radiology Physician
ME126598
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20000820
MEDICARE
ID
01
—
U000075283
MEDICARE
UT
Enumeration date
05/04/2006
Last updated
01/29/2016
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