Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MD466364 | PA |
NPI | 1013322486 |
---|---|
Provider Name | Dr. Daniel Shanin |
First Address | Philadelphia, PA 19143-1900 |
Second Address | Philadelphia, PA 19152 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2014 |
Last Update Date | 28/05/2019 |