Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | MD023053E | PA |
N | 207VX0000X | Obstetrician | MD023053E | PA |
NPI | 1407959620 |
---|---|
Provider Name | Dr. Mason J Carp |
First Address | Harrisburg, PA 17112-1025 |
Second Address | Harrisburg, PA 17112-1025 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 25/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C31008 | (02) |