Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 207X00000X | Orthopaedic Surgery | | MD028504E | PENNSYLVANIA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 0040138000 | OTHER | | INDEPENDENCE BLUE CROSS |
| 2 | 0338212 | OTHER | | CIGNA HEALTHCARE |
| 3 | 427702 | OTHER | | HIGHMARK BLUE SHIELD |
| 4 | P2754193 | OTHER | | OXFORD HEALTH PLANS |
| 5 | 2170487 | OTHER | | MAMSI |
| 6 | 4401404 | OTHER | | AETNA PPO |
| 7 | 50053195 | OTHER | | KEYSTONE HEALTH CENTRAL |
| 8 | 821135 | OTHER | | FIRST PRIORITY HEALTH |
| 9 | P00261407 | OTHER | | RAILROAD MEDICARE |
| 10 | 1551392 | OTHER | | UNITED HEALTHCARE |
| 11 | 39160 | OTHER | | GEISINGER HEALTH PLAN |
| 12 | 405660 | OTHER | | HEALTH AMERICA/HEALTH ASS |
| 13 | 0040138000 | OTHER | | AMERIHEALTH |
| 14 | 0040138000 | OTHER | | KEYSTONE HEALTH EAST |
| 15 | 9001653 | OTHER | | PRIVATE HEALTHCARE SYSTEM |
| 16 | B41625 | MEDICARE UPIN | PENNSYLVANIA | |
| 17 | 001058210002 | MEDICAID | PENNSYLVANIA | |
| 18 | 427702 | MEDICARE PIN | | |
| 19 | 50053195 | OTHER | | CAPITAL BLUE CROSS |
