Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD468319 | PA |
Y | 208600000X | Surgeon | MD468319 | PA |
N | 2086S0122X | Plastic and Reconstructive Surgery | D79733 | MD |
NPI | 1003842170 |
---|---|
Provider Name | Monique Lisa Abner |
First Address | Reading, PA 19612-3579 |
Second Address | Hagerstown, MD 21742-6710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 29/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1059R | BCBS (01) | NC |
1341310 | UNITED HEALTHCARE (01) | NC |
G47985 | (02) |