Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | MD016127E | PA |
NPI | 1104903608 |
---|---|
Provider Name | Dr. Gill R Alderfer |
First Address | Media, PA 19063-1019 |
Second Address | Ridley Park, PA 19078-1703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B40402 | (02) | PA |