Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 67307 | CT |
N | 2080P0202X | Pediatric Cardiologist | MD425362 | PA |
NPI | 1164466892 |
---|---|
Provider Name | Dr. Cesar Igor Mesia |
First Address | Chester Springs, PA 19425-1729 |
Second Address | Philadelphia, PA 19134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 25/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1011370300001 | (05) | PA |
H27507 | (02) |