Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2086S0129X | Vascular Surgeon | 207424 | NY |
Y | 2086S0129X | Vascular Surgeon | D57830 | MD |
NPI | 1174605323 |
---|---|
Provider Name | David B Gitlitz |
First Address | Baltimore, MD 21264-4226 |
Second Address | Baltimore, MD 21201-1544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 14/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
DG097Y0610 | (05) | NY |
H02702 | (02) |