Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | MD026755L | PA |
NPI | 1336195569 |
---|---|
Provider Name | Mr. Albert Bauer Knouse SR. |
First Address | York, PA 17402-3735 |
Second Address | York, PA 17402-3735 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B32141 | (02) | PA |