Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD440429 | PA |
N | 2080P0203X | Pediatric Critical Care Doctor | 031973 | CT |
Y | 2080P0203X | Pediatric Critical Care Doctor | MD440429 | PA |
NPI | 1023099330 |
---|---|
Provider Name | Dr. Michael Apkon |
First Address | Philadelphia, PA 19107-3323 |
Second Address | Philadelphia, PA 19104-4399 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2005 |
Last Update Date | 11/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001319731 | (05) | CT |
1024895200001 | (05) | PA |
186240EMD | MEDICARE PTAN (01) | PA |
F79427 | (02) |