Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic |
NPI | 1275954380 |
---|---|
Provider Name | Mr. Michael Shiffert |
First Address | Quakertown, PA 18951-2613 |
Second Address | Quakertown, PA 18951-2613 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/12/2013 |
Last Update Date | 17/12/2013 |