Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | MD019549E | PA |
NPI | 1003835737 |
---|---|
Provider Name | Dr. Gregory B Patrick |
First Address | Sewickley, PA 15143 |
Second Address | Sewickley, PA 15143 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 16/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0007977310011 | (05) | PA |
B36522 | (02) |