Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | OS012318 | PA |
N | 207RX0202X | Medical Oncology | OSO12318 | PA |
NPI | 1225094212 |
---|---|
Provider Name | Ingrid Follweiler Kohut |
First Address | Philadelphia, PA 19106-3500 |
Second Address | Philadelphia, PA 19106-3500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 16/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I51576 | (02) |