Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | C7-0002439 | DE |
N | 208600000X | Surgeon | C7-0002439 | DE |
N | 2086S0102X | Surgical Critical Care | MD430980 | PA |
Y | 2086S0127X | Trauma Surgeon | MD430980 | PA |
NPI | 1346376365 |
---|---|
Provider Name | Dr. Adam Michael Shiroff |
First Address | Philadelphia, PA 19104-2640 |
Second Address | Philadelphia, PA 19104-2640 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 06/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0156868 | (05) | NJ |
P01015955 | RR MCR (01) | NJ |