Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DS028769L | PA |
NPI | 1134284896 |
---|---|
Provider Name | Dr. Heidi L Myshin |
First Address | Camp Hill, PA 17011-2250 |
Second Address | Camp Hill, PA 17011-2250 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2006 |
Last Update Date | 28/08/2020 |