Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0200X | Critical Care Medicine | MD039888E | PA |
Y | 207RP1001X | Pulmonary Disease | MD039888E | PA |
NPI | 1063433746 |
---|---|
Provider Name | Earl D. King |
First Address | Philadelphia, PA 19140-5103 |
Second Address | Philadelphia, PA 19140-5103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 21/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F71165 | (02) | PA |