Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 13772 | MD |
NPI | 1780657130 |
---|---|
Provider Name | Dr. James John Sciubba |
First Address | Timonium, MD 21093-2116 |
Second Address | Timonium, MD 21093-2116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 16/07/2013 |