Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | OT019496 | PA |
NPI | 1013478965 |
---|---|
Provider Name | Denise Marie Inman |
First Address | Charleston, WV 25304-2722 |
Second Address | Danville, PA 17822-9800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2019 |
Last Update Date | 26/06/2019 |