Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD027326E | PA |
N | 208600000X | Surgeon | MD027326E | PA |
Y | 2086S0129X | Vascular Surgeon | MD027326E | PA |
N | 208C00000X | Colorectal Surgeon | MD027326E | PA |
NPI | 1114980570 |
---|---|
Provider Name | Philip G Georgevich |
First Address | Mc Kees Rocks, PA 15136-1616 |
Second Address | Mc Kees Rocks, PA 15136-1616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2006 |
Last Update Date | 15/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B42042 | (02) | PA |