Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | MD067189L | PA |
NPI | 1053325548 |
---|---|
Provider Name | Craig A Landow |
First Address | Plymouth Meeting, PA 19462-1421 |
Second Address | Broomall, PA 19008-3402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 05/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H14356 | (02) |