Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | 14350 | DC |
Y | 207KA0200X | Allergist | D33391 | MD |
NPI | 1518057397 |
---|---|
Provider Name | Denise Chevalier |
First Address | Largo, MD 20774-5341 |
Second Address | Largo, MD 20774-5341 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0443500 | (05) | DC |
21006 | (05) | MD |
B70674 | (02) |