Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MD418310 | PA |
NPI | 1033115092 |
---|---|
Provider Name | Shanthi Mohan |
First Address | Hanover, PA 17331-7902 |
Second Address | Hanover, PA 17331-7902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2005 |
Last Update Date | 02/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0018946870001 | (05) | PA |
G67805 | (02) | PA |