Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | MD035411E | PA |
NPI | 1023095114 |
---|---|
Provider Name | Charles H Pritchard |
First Address | Willow Grove, PA 19090-1709 |
Second Address | Willow Grove, PA 19090 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2005 |
Last Update Date | 09/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4398712 | AETNA (01) | |
B41041 | (02) |