Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MD20055 | DC |
N | 111NI0900X | Internist | MD20055 | DC |
Y | 207RX0202X | Medical Oncology | MD20055 | DC |
NPI | 1073136693 |
---|---|
Provider Name | Dr. Bernard Willis Parker |
First Address | Burtonsville, MD 20866-1662 |
Second Address | Burtonsville, MD 20866-1662 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2020 |
Last Update Date | 19/05/2020 |