Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN0400X | Neurology | DC2794 | PA |
N | 111NN1001X | Nutrition | DC2794 | PA |
N | 111NS0005X | Chiropractic Sports Physician | DC2794 | PA |
NPI | 1649475872 |
---|---|
Provider Name | Dr. Cary Simons |
First Address | Pittsburgh, PA 15224-0837 |
Second Address | Pittsburgh, PA 15224-2600 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
063993 | (02) | PA |
CH57880 | (02) | PA |