Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | OS019349 | PA |
Y | 207RC0000X | Internist - Cardiovascular Disease | OS019349 | PA |
NPI | 1619264637 |
---|---|
Provider Name | Dr. Brian Michael Corbally |
First Address | Harrisburg, PA 17110-3685 |
Second Address | Wormleysburg, PA 17043-1034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2011 |
Last Update Date | 21/01/2021 |