Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | SC007147 | PA |
N | 222Z00000X | Podiatrist | SC007147 | PA |
N | 213EP0504X | Public Medicine | SC007147 | PA |
N | 213EP1101X | Primary Podiatric Medicine | SC007147 | PA |
N | 111NR0200X | Radiology | SC007147 | PA |
N | 213ER0200X | Radiology | SC007147 | PA |
N | 2081S0010X | Sports Medicine | SC007147 | PA |
N | 213ES0000X | Sports Medicine | SC007147 | PA |
Y | 213ES0103X | Foot & Ankle Surgery | SC007147 | PA |
NPI | 1326644873 |
---|---|
Provider Name | Dr. Suna Panah |
First Address | Conshohocken, PA 19428-1120 |
Second Address | Plymouth Meeting, PA 19462-2483 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2020 |
Last Update Date | 09/12/2020 |