Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | D40009 | MD |
NPI | 1952401267 |
---|---|
Provider Name | Dr. Craig Mark Person |
First Address | Greenbelt, MD 20770-3514 |
Second Address | Greenbelt, MD 20770-3514 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
090141500 | (05) | MD |
E60152 | (02) | MD |