Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | MD462470 | PA |
NPI | 1225441959 |
---|---|
Provider Name | Dr. Charles Christian Vining |
First Address | Hershey, PA 17033-2391 |
Second Address | Hershey, PA 17033-2391 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2014 |
Last Update Date | 17/09/2021 |