Individual
JUSTIN SEROY
Active
Individual
JUSTIN SEROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
006635
AZ
207RI0200X
Infectious Disease Physician
036.132166
IL
390200000X
Student in an Organized Health Care Education/Training Program
125057500
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125057500
STATE LICENSE
IL
Enumeration date
08/31/2010
Last updated
08/23/2019
Update your record
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