Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0214X | Pediatric Pulmonologist | 219101-1 | NY |
Y | 2080P0214X | Pediatric Pulmonologist | MD472414 | PA |
NPI | 1124009444 |
---|---|
Provider Name | Kevin F Ferguson |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-1524 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2005 |
Last Update Date | 25/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001397240 | (05) | CT |