Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | MD424275 | PA |
NPI | 1063449809 |
---|---|
Provider Name | Jonathan B Bingham |
First Address | Allentown, PA 18103-5622 |
Second Address | Allentown, PA 18103-6271 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 18/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101507900 | (05) | PA |
I0415 | (02) | PA |
I04513 | (02) |