Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | MD051358L | PA |
NPI | 1003912189 |
---|---|
Provider Name | Dr. Joseph H Nour |
First Address | Fombell, PA 16123-2109 |
Second Address | Butler, PA 16001-1785 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 18/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F86208 | (02) | PA |