Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 036-082513 | IL |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | MD049569L | PA |
N | 207VG0400X | Gynecologist | 036-082513 | IL |
N | 207VG0400X | Gynecologist | MD049569L | PA |
NPI | 1962419788 |
---|---|
Provider Name | Sandra Culbertson |
First Address | Danville, PA 17822-4903 |
Second Address | Danville, PA 17822-1447 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2006 |
Last Update Date | 19/11/2020 |