Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD438026 | PA |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | MD438026 | PA |
NPI | 1053567172 |
---|---|
Provider Name | Dr. Dov A Bader |
First Address | Hershey, PA 17033-0858 |
Second Address | State College, PA 16803-6706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2008 |
Last Update Date | 22/09/2015 |