Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | D0057603 | MD |
NPI | 1003885609 |
---|---|
Provider Name | Anita Iyer |
First Address | Brentwood, TN 37027 |
Second Address | Bethesda, MD 20817-1154 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2006 |
Last Update Date | 13/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H50289 | (02) | MD |