Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD31003 | DC |
Y | 2080N0001X | Neonatal-Perinatal Doctor | MD31003 | DC |
NPI | 1023080074 |
---|---|
Provider Name | Dr. Angela Patterson |
First Address | Silver Spring, MD 20902-2945 |
Second Address | Washington, DC 20010-2976 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2006 |
Last Update Date | 08/10/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G77164 | (02) | DC |