Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | D0064447 | MD |
NPI | 1073568721 |
---|---|
Provider Name | Dr. Deep H Dalal |
First Address | Glen Burnie, MD 21061-4099 |
Second Address | Glen Burnie, MD 21061-4099 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 14/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
410786100 | (05) | MD |
I47847 | (02) | MD |