Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD021257E | PA |
Y | 2080P0208X | Pediatric Infectious Diseases | MD021257E | PA |
NPI | 1568476430 |
---|---|
Provider Name | Paul A Offit |
First Address | Philadelphia, PA 19107-3323 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 06/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001099035 | (05) | PA |
2501902 | (05) | NJ |
A53172 | (02) |