Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD450881 | PA |
N | 208000000X | Pediatrician | MT200368 | PA |
Y | 2080P0201X | Pediatric Allergist | D85569 | MD |
NPI | 1598050536 |
---|---|
Provider Name | Dr. Jennifer Dantzer |
First Address | Baltimore, MD 21236-4902 |
Second Address | Baltimore, MD 21287-0005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2011 |
Last Update Date | 21/03/2019 |