Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0205X | Pediatric Endocrinologist | L1862 | TX |
Y | 2080P0205X | Pediatric Endocrinologist | MD435713 | PA |
NPI | 1356340012 |
---|---|
Provider Name | Mushtaq A Godil |
First Address | Danville, PA 17822-9800 |
Second Address | Danville, PA 17872-4903 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2005 |
Last Update Date | 30/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H53502 | (02) | TX |