Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 00317 | MD |
NPI | 1407849607 |
---|---|
Provider Name | Dr. Burton Joel Katzen |
First Address | Potomac, MD 20854 |
Second Address | Temple Hills, MD 20748 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T30880 | (02) |