Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | DC005021L | PA |
NPI | 1831118546 |
---|---|
Provider Name | Dr. Kurt Randall Schichtl |
First Address | Emmaus, PA 18049-1920 |
Second Address | Emmaus, PA 18049-1920 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 08/07/2007 |