Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | D0020704 | MD |
NPI | 1174523567 |
---|---|
Provider Name | Bruno Abilio Chumpitazi |
First Address | Potomac, MD 20854-1505 |
Second Address | Silver Spring, MD 20901-4532 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 25/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B94234 | (02) | MD |