Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | MD012730E | PA |
NPI | 1023002904 |
---|---|
Provider Name | Thomas J Yucha |
First Address | Camp Hill, PA 17011-2208 |
Second Address | Camp Hill, PA 17011-2208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B36479 | (02) | PA |