Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | OS018129 | PA |
NPI | 1134469992 |
---|---|
Provider Name | Dr. Michael Alan Shafran |
First Address | Newtown, PA 18940-3413 |
Second Address | Newtown, PA 18940-3413 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2013 |
Last Update Date | 28/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
FS3756876 | DEA (01) | PA |
OS018129 | MEDICAL LICENSE (01) | PA |