Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | MD048548L | PA |
NPI | 1144243858 |
---|---|
Provider Name | Margaret Von-Mehren |
First Address | Philadelphia, PA 19129-1302 |
Second Address | Philadelphia, PA 19111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 08/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0015950510003 | (05) | PA |
G30900 | (02) | PA |