Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | D0053220 | MD |
NPI | 1124178876 |
---|---|
Provider Name | Adrienne H Suggs |
First Address | Columbia, MD 21044-5701 |
Second Address | Baltimore, MD 21237-3901 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 29/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
75859901 | BLUE SHIELD (01) | MD |
G23185 | (02) | MD |