Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD427794 | PA |
N | 208600000X | Surgeon | MD427794 | PA |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD427794 | PA |
NPI | 1083783179 |
---|---|
Provider Name | Christian Andres Bermudez |
First Address | Philadelphia, PA 19104-2640 |
Second Address | Philadelphia, PA 19104-2640 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 22/10/2019 |