Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD055634L | PA |
NPI | 1649230632 |
---|---|
Provider Name | Adam Combs Abram |
First Address | Mechanicsburg, PA 17050-9400 |
Second Address | Mechanicsburg, PA 17050-9400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 09/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F82107 | (02) |