Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | MD028917E | PA |
NPI | 1073583191 |
---|---|
Provider Name | Dr. M. Mohamed Meeran |
First Address | Philadelphia, PA 19178-3311 |
Second Address | Pottsville, PA 17901-3636 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2006 |
Last Update Date | 05/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0010131660002 | (05) | PA |
C26094 | (02) | PA |