Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | MD022183E | PA |
NPI | 1003884586 |
---|---|
Provider Name | Michael Carson Sinclair |
First Address | Allentown, PA 18102-3406 |
Second Address | Allentown, PA 18102-3472 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 11/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0006407890008 | (05) | PA |
0040164000 | IBC (01) | |
105256 | HIGHMARK BLUE SHIELD (01) | PA |
1518431 | GATEWAY HEALTH PLAN (01) | |
187958 | UNISON (01) | |
20049133 | AMERIHEALTH MERCY (01) | |
50057845 | CBC (01) | |
B36603 | (02) | PA |