Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | OS-009625-L | PA |
NPI | 1487655544 |
---|---|
Provider Name | Dr. Jeffrey Joseph Sewecke |
First Address | Pittsburgh, PA 15212-4769 |
Second Address | Pittsburgh, PA 15212-4769 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 06/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G74517 | (02) | PA |