Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | MD019305E | PA |
NPI | 1114999026 |
---|---|
Provider Name | Noah Bass |
First Address | Pittsburgh, PA 15203-2348 |
Second Address | Pittsburgh, PA 15232-1531 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2006 |
Last Update Date | 25/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B40802 | (02) | PA |