Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD071095L | PA |
N | 2081S0010X | Sports Medicine | MD071095L | PA |
N | 213ES0000X | Sports Medicine | MD071095L | PA |
NPI | 1275597270 |
---|---|
Provider Name | Paul S Sherbondy |
First Address | Hershey, PA 17033-0858 |
Second Address | State College, PA 16803-6706 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 22/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0018163950001 | (05) | PA |
G89592 | (02) |