Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD33236 | DC |
NPI | 1003818196 |
---|---|
Provider Name | Dr. David Jeffrey Eisenman |
First Address | Baltimore, MD 21201-1606 |
Second Address | Baltimore, MD 21201-1606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2005 |
Last Update Date | 13/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H54777 | (02) |