Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD038830L | PA |
NPI | 1023011293 |
---|---|
Provider Name | Dr. Fereydoon Adibi |
First Address | Harleysville, PA 19438-0907 |
Second Address | Quakertown, PA 18951-1272 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 03/04/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0007846170006 | (05) | PA |
B33523 | (02) | PA |