Doctor Name: | NOVAE BERNADETTE SIMPER |
NPI Number: | 1417005802 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 01062999A |
Business Practice Address: | Madigan Army Medical Ctr Attn Mchj-h Department Of Pathology Tacoma, WA - 984310001 |
Business Phone Number: | 2539681708 |
Business Fax Number: | 2539681548 |
Mailing Address: | 429 8th Ave Ne, PUYALLUP |
State: | WA |
Postal Code: | 983722939 |
Phone Number: | 2532680136 |
Fax Number: | |
NPI Enumeration Date: | 01/08/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 01062999A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |