Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | OS006160L | PA |
N | 207ND0101X | MOHS-Micrographic Surgeon | 4575 | OK |
N | 207NS0135X | Procedural Dermatology | 4575 | OK |
NPI | 1285695122 |
---|---|
Provider Name | Carol D Cola |
First Address | Limerick, PA 19468-4295 |
Second Address | Limerick, PA 19468-4295 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2006 |
Last Update Date | 13/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01720128 | RAILROAD MEDICARE (01) | PA |
0452366000 | INDEPENDENCE BLUE CROSS (01) | PA |
100749090B | (05) | OK |
1014066 | KEYSTONE MERCY (01) | PA |
451708 | AETNA (01) | PA |
50018326 | CAPITOL BLUE CROSS (01) | PA |
622829 | HIGHMARK BLUE SHIELD (01) | PA |
E52515 | (02) |