Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | R186559 | MD |
NPI | 1023401429 |
---|---|
Provider Name | Christopher Kolokythas |
First Address | Baltimore, MD 21201-1544 |
Second Address | Baltimore, MD 21201-1544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2015 |
Last Update Date | 09/03/2015 |