Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | MD028728E | PA |
NPI | 1063512663 |
---|---|
Provider Name | John F Shulman |
First Address | Philadelphia, PA 19107-1511 |
Second Address | Philadelphia, PA 19107-1511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2006 |
Last Update Date | 21/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001216365 | (05) | PA |
E59208 | (02) |