Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 70549 | MD |
NPI | 1003073859 |
---|---|
Provider Name | Dr. Erica Rupar |
First Address | Silver Spring, MD 20902-5020 |
Second Address | Silver Spring, MD 20902-5020 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2008 |
Last Update Date | 25/04/2012 |