Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | MD429166 | PA |
NPI | 1184638561 |
---|---|
Provider Name | Michael Gimbel |
First Address | Pittsburgh, PA 15261-0001 |
Second Address | Pittsburgh, PA 15206-3721 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 25/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I38138 | (02) | CA |