Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | D0020489 | MD |
Y | 2080P0201X | Pediatric Allergist | D0020489 | MD |
NPI | 1407839913 |
---|---|
Provider Name | Dr. Kenneth Charles Schuberth |
First Address | Lutherville, MD 21093-4591 |
Second Address | Lutherville, MD 21093-4591 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 01/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B66923 | (02) | MD |