Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 7886 | MD |
NPI | 1053534743 |
---|---|
Provider Name | Dr. Edward Lee Ginsberg |
First Address | Baltimore, MD 21209-1500 |
Second Address | Catonsville, MD 21228-3826 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7886 | STATE DENTAL LICENSE (01) | MD |