Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | D0020919 | MD |
NPI | 1033439666 |
---|---|
Provider Name | Dr. Jimmy Pimentel Cua |
First Address | Lutherville, MD 21093-3979 |
Second Address | Lutherville, MD 21093-3979 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2010 |
Last Update Date | 05/06/2010 |