Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OS008131L | PA |
NPI | 1457342347 |
---|---|
Provider Name | Dr. Marianne Herr Paul |
First Address | Greencastle, PA 17225-8305 |
Second Address | Greencastle, PA 17225-8305 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2005 |
Last Update Date | 16/12/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F12825 | (02) | PA |