Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | MD457553 | PA |
NPI | 1215370952 |
---|---|
Provider Name | Bryan Paul Stefek |
First Address | Hershey, PA 17033-0858 |
Second Address | Harrisburg, PA 17112-3248 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2013 |
Last Update Date | 07/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103629017 | (05) | PA |