Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208D00000X | General Practice Physician | OS002457L | PA |
NPI | 1033295225 |
---|---|
Provider Name | Dr. Marshall Harris Sager |
First Address | Bala Cynwyd, PA 19004-1207 |
Second Address | Bala Cynwyd, PA 19004-1207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2006 |
Last Update Date | 08/03/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E98041 | (02) |