Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OS012940 | PA |
NPI | 1003000407 |
---|---|
Provider Name | David James Girardi |
First Address | Pittsburgh, PA 15221-2134 |
Second Address | Pittsburgh, PA 15221-2134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2007 |
Last Update Date | 14/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102021110 | (05) | PA |