Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | D63510 | MD |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | D0063510 | MD |
NPI | 1184687493 |
---|---|
Provider Name | Dr. James Christiaan Dreese |
First Address | Baltimore, MD 21264-4134 |
Second Address | Baltimore, MD 21207-6665 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2006 |
Last Update Date | 12/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1184687493 | NPI (01) | MD |
409117500 | (05) | MD |
I05463 | (02) | MD |