Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207ND0101X | MOHS-Micrographic Surgeon | MD065115L | PA |
N | 207NS0135X | Procedural Dermatology | MD065115L | PA |
NPI | 1023036282 |
---|---|
Provider Name | Donald Raymond D'annunzio |
First Address | Camp Hill, PA 17011-1807 |
Second Address | Camp Hill, PA 17011-1807 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01734201 | CAPITAL BLUE CROSS (01) | PA |
267274 | BLUE SHIELD (01) | PA |
G46913 | (02) | PA |