Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | MD031017L | PA |
NPI | 1033362116 |
---|---|
Provider Name | Dr. Iain Lewis Mackenzie |
First Address | York, PA 17403 |
Second Address | York, PA 17403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2008 |
Last Update Date | 03/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B33838 | (02) | PA |