Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | MD035692 | DC |
NPI | 1396883930 |
---|---|
Provider Name | Dr. Jeffrey Jerome Pelton |
First Address | Bethesda, MD 20817-2542 |
Second Address | Washington, DC 20002-8100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2007 |
Last Update Date | 22/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H28388 | (02) | CA |