Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | S01447 | MD |
N | 111NS0005X | Chiropractic Sports Physician | S01447 | MD |
NPI | 1417949868 |
---|---|
Provider Name | Dr. Kathryn A. Hodges |
First Address | Chester, MD 21619 |
Second Address | Annapolis, MD 21401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2005 |
Last Update Date | 20/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2089 | BCBS-DC PROVIDER ID (01) | DC |
239091 | UHC,MAMSI,MDIPA,OPTCH ID (01) | MD |
521800109 | TAX ID# (01) | MD |
M339KA | CAREFIRST BCBS MD PROV ID (01) | MD |
U10096 | (02) | MD |