Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD061709L | PA |
Y | 2080P0203X | Pediatric Critical Care Doctor | MD061709L | PA |
NPI | 1023122553 |
---|---|
Provider Name | Jimmy W Huh |
First Address | Philadelphia, PA 19107-3323 |
Second Address | Philadelphia, PA 19104-4399 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2006 |
Last Update Date | 11/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0017993560 | (05) | PA |
038943EMD | MEDICARE PTAN (01) | PA |
G14350 | (02) | PA |