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General NPI Number Information
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NPI Number | 1639577737
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Entity Type | Organization
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Legal Business Name | SHENGGAO HAN MD LLC
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Dates
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Enumeration Date | 12/05/2014
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Last Update Date | 12/05/2014
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Provider Practice Location Address
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Address Line | 625 RUSTIC LODGE RD SUITE B
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City | INDIANA
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State | PA
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Zip | 15701-3440
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Country | US
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Telephone | 724-463-3720
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Fax | 724-463-6111
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Provider Business Mailing Address
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Address Line | 625 RUSTIC LODGE RD SUITE B
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City | INDIANA
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State | PA
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Zip | 15701-3440
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Country | US
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Telephone | 724-463-3720
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Fax | 724-463-6111
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ROBERT PAUL SNYDER
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Credential | D.O.
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Telephone | 412-841-1994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS009746L
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License Number State | PA
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