Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | MD060495L | PA |
NPI | 1063575561 |
---|---|
Provider Name | Dr. Daniel R Nevarre |
First Address | Johnstown, PA 15904-6800 |
Second Address | Johnstown, PA 15901-2504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 10/07/2007 |