Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | SC002981L | PA |
N | 111NR0200X | Radiology | SC002981L | PA |
N | 213ER0200X | Radiology | SC002981L | PA |
N | 213ES0103X | Foot & Ankle Surgery | SC002981L | PA |
NPI | 1073502076 |
---|---|
Provider Name | Dr. Michael Scott Downey |
First Address | Philadelphia, PA 19104-3153 |
Second Address | Philadelphia, PA 19104-3153 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2005 |
Last Update Date | 04/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0010546500005 | (05) | PA |
T30356 | (02) |