Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | MT195611 | PA |
NPI | 1144457961 |
---|---|
Provider Name | Dr. Ankur Janak Shukla |
First Address | Pittsburgh, PA 15232-1214 |
Second Address | Pittsburgh, PA 15213-2536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2009 |
Last Update Date | 18/06/2009 |