Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | D57060 | MD |
NPI | 1023086303 |
---|---|
Provider Name | Dr. Hollis C. Reid |
First Address | Perry Hall, MD 21128-9815 |
Second Address | Perry Hall, MD 21128-9815 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C09156 | (02) |