Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 030690-L | PA |
NPI | 1093046724 |
---|---|
Provider Name | Dr. Fouad Adib Geadah |
First Address | Camp Hill, PA 17011-1641 |
Second Address | Camp Hill, PA 17011-1641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2010 |
Last Update Date | 25/02/2010 |