Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0201X | Internist - Allergy & Immunology | MD049972L | PA |
Y | 207RP1001X | Pulmonary Disease | MD049972L | PA |
NPI | 1811973803 |
---|---|
Provider Name | Albert G Driver JR. |
First Address | Harleysville, PA 19438-0907 |
Second Address | Sellersville, PA 18960-1579 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2005 |
Last Update Date | 27/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C83573 | (02) | PA |