Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD043956E | PA |
N | 111NI0900X | Internist | MD043956E | PA |
N | 207RG0300X | Geriatric Medicine | D35763 | MD |
Y | 207RG0300X | Geriatric Medicine | MD043956E | PA |
N | 207RH0002X | Hospice and Palliative Medicine | MD043956E | PA |
NPI | 1306893425 |
---|---|
Provider Name | Grace Ann Cordts |
First Address | York, PA 17402-9001 |
Second Address | York, PA 17403-5151 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2006 |
Last Update Date | 17/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
287011800 | (05) | MD |
B69102 | (02) | MD |