Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MD435776 | PA |
NPI | 1063650380 |
---|---|
Provider Name | Dr. Amir R. Dehdashti |
First Address | Danville, PA 17822-3034 |
Second Address | Danville, PA 17822-1405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2009 |
Last Update Date | 23/01/2009 |