Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD064894L | PA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD064894L | PA |
NPI | 1235108952 |
---|---|
Provider Name | Dr. Brian A Batman |
First Address | Mifflinburg, PA 17844-0111 |
Second Address | Lewisburg, PA 17837-9367 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2006 |
Last Update Date | 20/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F88577 | (02) | PA |