Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | MD044433 | DC |
N | 208000000X | Pediatrician | MD044433 | DC |
NPI | 1003235367 |
---|---|
Provider Name | Dr. Charles John Billington JR. |
First Address | Minneapolis, MN 55454-1455 |
Second Address | Washington, DC 20010-2916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2014 |
Last Update Date | 17/04/2020 |