Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | SC006411 | PA |
NPI | 1356606347 |
---|---|
Provider Name | Melissa D Shinder |
First Address | Philadelphia, PA 19152-3038 |
Second Address | Mount Laurel, NJ 08054-3188 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2012 |
Last Update Date | 03/02/2016 |