Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | MD049656L | PA |
Y | 208600000X | Surgeon | MD049656L | PA |
N | 2086S0102X | Surgical Critical Care | MD049656L | PA |
NPI | 1154357200 |
---|---|
Provider Name | Steven Eugene Raper |
First Address | Philadelphia, PA 19104 |
Second Address | Philadelphia, PA 19104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 10/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0014138920001 | (05) | PA |
B48643 | (02) |