Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081S0010X | Sports Medicine | A0000960 | MD |
Y | 213ES0000X | Sports Medicine | A0000960 | MD |
NPI | 1194368712 |
---|---|
Provider Name | Courtney Donald |
First Address | Glen Burnie, MD 21061-4948 |
Second Address | Bowie, MD 20715-3319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2019 |
Last Update Date | 20/12/2020 |