Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | D36497 | MD |
NPI | 1023073749 |
---|---|
Provider Name | Dr. David W Eisele |
First Address | Baltimore, MD 21287-0006 |
Second Address | Baltimore, MD 21287-0006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 02/12/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G862180 | (05) | CA |
D72225 | (02) | CA |