Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | DC007727L | PA |
Y | 213ER0200X | Radiology | DC007727L | PA |
NPI | 1225127269 |
---|---|
Provider Name | Dr. Michael Ferrance |
First Address | Irvona, PA 16656 |
Second Address | Irvona, PA 16656 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 22/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
505883 | BCBS (01) | PA |
U80362 | (02) | PA |