Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | H0044538 | MD |
NPI | 1053488841 |
---|---|
Provider Name | Dr. Jeffrey T Nold |
First Address | Annapolis, MD 21401-7445 |
Second Address | Annapolis, MD 21401-7445 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 10/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G18806 | (02) | MD |