Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | D46370 | MD |
NPI | 1104854108 |
---|---|
Provider Name | Dr. Alvin Sanico |
First Address | Towson, MD 21204-5826 |
Second Address | Towson, MD 21204-5826 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 17/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
841101800 | (05) | MD |
G75330 | (02) | MD |