Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | MD473939 | PA |
NPI | 1386905453 |
---|---|
Provider Name | Joseph Church |
First Address | Pittsburgh, PA 15224 |
Second Address | Pittsburgh, PA 15224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2012 |
Last Update Date | 27/07/2021 |