Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | 0101020960 | VA |
N | 2080P0201X | Pediatric Allergist | D0020026 | MD |
N | 2080P0201X | Pediatric Allergist | MD6449 | DC |
NPI | 1821153172 |
---|---|
Provider Name | Dr. John R Vroom |
First Address | Rockville, MD 20852-4908 |
Second Address | Springfield, VA 22150-1885 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2006 |
Last Update Date | 21/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C88631 | (02) |