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General NPI Number Information
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NPI Number | 1700867686
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Entity Type | Individual
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Provider Name | JOSE ENRIQUE MISAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 04/22/2021
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Provider Practice Location Address
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Address Line | 4310 LONDONDERRY RD SUITE 100
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City | HARRISBURG
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State | PA
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Zip | 17109-5300
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Country | US
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Telephone | 717-221-5940
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Fax | 717-233-2821
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Provider Business Mailing Address
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Address Line | 2494 BERNVILLE RD STE G02
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City | READING
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State | PA
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Zip | 19605-9466
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | MD023275E
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207VX0201X
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Taxonomy Name | Gynecologic Oncology Physician
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License Number | MD023275E
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License Number State | PA
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