Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | D-39190 | MD |
NPI | 1053392100 |
---|---|
Provider Name | Dr. Joseph Garrett Reilly |
First Address | Olney, MD 20832-1375 |
Second Address | Olney, MD 20832-1375 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 16/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
07701 | (05) | MD |
E-13402 | (02) | MD |