Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MD043835E | PA |
Y | 207QA0401X | Family Doctor - Addiction Medicine | MD043835E | PA |
NPI | 1780755710 |
---|---|
Provider Name | David R Battista |
First Address | Somerset, PA 15501-0844 |
Second Address | Somerset, PA 15501-2033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 01/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
565691 | (02) | PA |