Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD30725 | DC |
N | 207RA0201X | Internist - Allergy & Immunology | MD30725 | DC |
NPI | 1376606624 |
---|---|
Provider Name | Dan Taliaferro Brody |
First Address | Washington, DC 20006-1009 |
Second Address | Washington, DC 20006-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2006 |
Last Update Date | 04/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H56912 | (02) |