Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | L8587 | TX |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 047348 | CT |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | D85984 | MD |
NPI | 1164495925 |
---|---|
Provider Name | Dr. Christine Ajjan Laky |
First Address | Belfast, ME 04915-4017 |
Second Address | Annapolis, MD 21401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2006 |
Last Update Date | 01/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
222363500 | (05) | MD |
716871 | MEDICARE (01) | MD |
716876 | MEDICARE (01) | MD |
K480009 | CAREFIRST BCBS (01) | MD |