Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MB55629 | NJ |
Y | 207X00000X | Orthopaedic Surgeon | OS-007347-E | PA |
NPI | 1003810045 |
---|---|
Provider Name | Dr. Donald Durand Diverio JR. |
First Address | Lancaster, PA 17603-4349 |
Second Address | Lancaster, PA 17603-4349 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 24/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001240665 | (05) | PA |
E86192 | (02) | PA |