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PRODROMOS A VERVERELI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
400 ELK CHASE CT, TAYLORSVILLE, KY 40071-7260
(610) 390-8228
Mailing address
400 ELK CHASE CT, TAYLORSVILLE, KY 40071-7260
(610) 390-8228

Taxonomy

Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
55069
KY
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
MD044774L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0015347530003
PA
Enumeration date
06/22/2005
Last updated
07/31/2023
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