Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | A76036 | CA |
NPI | 1013982529 |
---|---|
Provider Name | Dr. Jeremy Alan King |
First Address | Sparks, MD 21152-8842 |
Second Address | Lutherville, MD 21093-4609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2006 |
Last Update Date | 08/07/2007 |