Husodo, Indrawan

Husodo, Indrawan is an individual health care provider with primary practice located at 990 Sylvan Way , Bremerton WA 98310-2851. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Husodo, Indrawan can be contacted via phone (360) 479-3657.

Contact Information

Primary practice address
990 Sylvan Way Bremerton WA 98310-2851
Phone: (360) 479-3657
Fax: (360) 373-7616
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X MD00028376 Washington

Profile Details

NPI number 1376541847
LBN Legal business name Husodo, Indrawan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2005
Last updated Jan 21st, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376541847 NPPES
Washington Other 72669 LABOR AND INDUSTRIES
Washington Other HU0090 LABOR AND INDUSTRIES
Washington MEDICAID 8132292 LABOR AND INDUSTRIES
Washington Other 91084721521 LABOR AND INDUSTRIES
Washington Other 06487001 LABOR AND INDUSTRIES
Washington Other 910847215 LABOR AND INDUSTRIES
Washington Other 050042796 LABOR AND INDUSTRIES
Washington Other 8933482 LABOR AND INDUSTRIES

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