Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MD465037 | PA |
Y | 111NI0900X | Internist | MD465037 | PA |
N | 207R00000X | Internist | MT209805 | PA |
N | 111NI0900X | Internist | MT209805 | PA |
NPI | 1003290628 |
---|---|
Provider Name | Quan Tran |
First Address | Harrisburg, PA 17104-1612 |
Second Address | Harrisburg, PA 17101-2010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2015 |
Last Update Date | 09/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103338341 | (05) | PA |