Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | D0021503 | MD |
NPI | 1346361524 |
---|---|
Provider Name | Dr. Avigdor Izsak Niv |
First Address | Baltimore, MD 21209-1027 |
Second Address | Baltimore, MD 21209-1027 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 08/07/2007 |