Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | MD-032411-E | PA |
NPI | 1003863937 |
---|---|
Provider Name | Dr. Mark Bennet Kahn |
First Address | Philadelphia, PA 19119-3712 |
Second Address | Wyndmoor, PA 19038-7976 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 27/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C68490 | (02) | PA |