Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | MD064276 | PA |
NPI | 1013933217 |
---|---|
Provider Name | Dr. Clarke U. Piatt |
First Address | Bryn Mawr, PA 19010-3231 |
Second Address | Bryn Mawr, PA 19010-3231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 05/04/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1030991080001 | (05) | PA |