Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 219275 | NY |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | MD446154 | PA |
NPI | 1730186404 |
---|---|
Provider Name | Dr. Radu Clifford Mihail |
First Address | Williamsport, PA 17701-1900 |
Second Address | Williamsport, PA 17701-2647 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 13/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02512105 | (05) | NY |
A59129 | (02) | NY |