Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD007758E | PA |
NPI | 1003286857 |
---|---|
Provider Name | Dr. John Robert Utberg |
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 | 05/10/2015 |
Last Update Date | 05/10/2015 |