Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | MD440496 | PA |
NPI | 1003008574 |
---|---|
Provider Name | Dr. Eric R. Ginn |
First Address | Bryn Mawr, PA 19010-3121 |
Second Address | Bryn Mawr, PA 19010-3121 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2007 |
Last Update Date | 01/05/2017 |