Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 2005 | PR |
NPI | 1881678944 |
---|---|
Provider Name | Dr. Jose Ernesto Colon |
First Address | Silver Spring, MD 20910-3156 |
Second Address | Washington, DC 20306-0003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2005 |
Last Update Date | 18/07/2008 |