Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | MD466766 | PA |
NPI | 1043630502 |
---|---|
Provider Name | Konrad Dziamski |
First Address | York, PA 17402-9001 |
Second Address | York, PA 17402-4648 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2014 |
Last Update Date | 11/09/2019 |