Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | MD014648E | PA |
NPI | 1063450849 |
---|---|
Provider Name | George Randolph Westby |
First Address | Upland, PA 19013-3955 |
Second Address | Upland, PA 19013-3955 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 08/07/2007 |