Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | MD021778E | PA |
NPI | 1386697993 |
---|---|
Provider Name | Barry R Smoger |
First Address | Philadelphia, PA 19104-4206 |
Second Address | Philadelphia, PA 19104-4206 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 22/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00909130 | (05) | PA |
B37297 | (02) | PA |