Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | OS003458L | PA |
NPI | 1063636033 |
---|---|
Provider Name | Dr. George Thomas Zahorian III |
First Address | Hershey, PA 17033-2217 |
Second Address | Hershey, PA 17033-2217 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2007 |
Last Update Date | 19/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100728097-0004 | (05) | PA |