Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 2009034592 | MO |
N | 2080P0216X | Pediatric Rheumatologist | 2009034592 | MO |
NPI | 1356545719 |
---|---|
Provider Name | Dr. Amanda Kilker Ombrello |
First Address | Bethesda, MD 20892-0001 |
Second Address | Bethesda, MD 20892-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2007 |
Last Update Date | 02/06/2016 |