Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD469975 | PA |
N | 111NI0900X | Internist | MD469975 | PA |
NPI | 1003256173 |
---|---|
Provider Name | Saba Memon |
First Address | Odessa, TX 79763-4206 |
Second Address | Chambersburg, PA 17201-1720 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2013 |
Last Update Date | 16/04/2020 |