Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | OS009514L | PA |
NPI | 1053321059 |
---|---|
Provider Name | Theresa White Mchugh |
First Address | Wynnewood, PA 19096 |
Second Address | Wynnewood, PA 19096 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 05/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H76572 | (02) |