Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | SC002864L | PA |
Y | 222Z00000X | Podiatrist | SC002864L | PA |
NPI | 1003889494 |
---|---|
Provider Name | Dr. Douglas F. Klepfer |
First Address | Ardmore, PA 19003-1917 |
Second Address | Ardmore, PA 19003-1917 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 30/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T29461 | (02) | PA |