Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 25MA07024600 | NJ |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | MD034226E | PA |
NPI | 1184663395 |
---|---|
Provider Name | Peter Francis Sharkey |
First Address | Philadelphia, PA 19107-4414 |
Second Address | Philadelphia, PA 19107-4216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 10/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0100172000 | IBC (01) | PA |
1031457 | AETNA (01) | PA |
4001099 | CIGNA (01) | |
C34072 | (02) |