Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD028411E | PA |
NPI | 1023005816 |
---|---|
Provider Name | Charles Lamade |
First Address | Williamsport, PA 17701-1900 |
Second Address | Williamsport, PA 17701-3102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2005 |
Last Update Date | 24/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B37087 | (02) |