Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MD 014493E | PA |
NPI | 1013960764 |
---|---|
Provider Name | Paul M Shipkin |
First Address | Jenkintown, PA 19046-2627 |
Second Address | Jenkintown, PA 19046-2627 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B40208 | (02) | PA |