Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 15650 | MD |
Y | 213EG0000X | General Practice | 15650 | MD |
NPI | 1003211814 |
---|---|
Provider Name | Dr. Caprice Marjenin |
First Address | Frederick, MD 21701-4348 |
Second Address | Frederick, MD 21701-4348 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2014 |
Last Update Date | 15/10/2020 |