Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 917278 | MD |
NPI | 1225232374 |
---|---|
Provider Name | Calman Philip Prussin |
First Address | Rockville, MD 20852-3716 |
Second Address | Bethesda, MD 20892-1881 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2007 |
Last Update Date | 08/07/2007 |