Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DA020977A | PA |
Y | 1223D0004X | Dentist Anesthesiologist | DA020977A | PA |
N | 1223D0004X | Dentist Anesthesiologist | DS020977L | PA |
N | 207L00000X | Anesthesiologist | DA020977A | PA |
NPI | 1699725382 |
---|---|
Provider Name | Terry T Durbin |
First Address | Harrisburg, PA 17104-1612 |
Second Address | York, PA 17403-4510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 12/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102767799 | (05) | PA |
U11575 | (02) |