Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD040466E | PA |
NPI | 1104806769 |
---|---|
Provider Name | Francis Ferdinand |
First Address | Wynnewood, PA 19096-3450 |
Second Address | Wynnewood, PA 19096-3450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 25/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H02536 | (02) |