Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 35.126456 | OH |
N | 2080P0214X | Pediatric Pulmonologist | 99080699A | IN |
NPI | 1558616250 |
---|---|
Provider Name | Dr. Michael Anthony Pena |
First Address | Akron, OH 44308-1063 |
Second Address | Akron, OH 44308-1063 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2012 |
Last Update Date | 12/04/2021 |