Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XP3100X | Pediatric Orthopaedic Surgeon | PA030461 | DC |
NPI | 1457480501 |
---|---|
Provider Name | Katie Elizabeth Scanlon |
First Address | Wilmington, DE 19806-4054 |
Second Address | Wilmington, DE 19806-4054 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2007 |
Last Update Date | 23/02/2011 |