Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | MD065985L | PA |
Y | 207VX0000X | Obstetrician | MD065985L | PA |
NPI | 1124071121 |
---|---|
Provider Name | Dr. Roger A. Hine |
First Address | York, PA 17402-9001 |
Second Address | Lebanon, PA 17042-7493 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2006 |
Last Update Date | 03/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100774032 | (05) | PA |
H11846 | (02) | PA |