Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QS0010X | Family Doctor - Sports Medicine | 0101225211 | VA |
Y | 207QS0010X | Family Doctor - Sports Medicine | D50570 | MD |
N | 207QS0010X | Family Doctor - Sports Medicine | MD30121 | DC |
NPI | 1043347149 |
---|---|
Provider Name | Dr. Caesar Augustus Junker |
First Address | Rockville, MD 20852 |
Second Address | Kensington, MD 20895 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I20074 | (02) |