Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | DS016446L | PA |
NPI | 1033195938 |
---|---|
Provider Name | Dr. Michael Roger Kahn |
First Address | Pittsburgh, PA 15208-2701 |
Second Address | Pittsburgh, PA 15206-3780 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 10/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0535460 | (05) | PA |
124300 | HIGHMARK BC BS (01) | PA |
T29616 | (02) |