Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD447274 | PA |
N | 207KA0200X | Allergist | 25MA08321700 | NJ |
N | 207RR0500X | Rheumatology | 4301035945 | MI |
NPI | 1073540076 |
---|---|
Provider Name | Dr. David A Axelrod |
First Address | York, PA 17403-4637 |
Second Address | York, PA 17403-4637 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2006 |
Last Update Date | 08/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0635238 | BLUE SHEILD OF MICHIGAN (01) | MI |
B43718 | (02) | MI |