Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | OS015168 | PA |
NPI | 1033236526 |
---|---|
Provider Name | Kimberly Beth Fuld |
First Address | Philadelphia, PA 19134-1043 |
Second Address | Philadelphia, PA 19134-1043 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 08/10/2010 |