Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | D0044584 | MD |
NPI | 1003817818 |
---|---|
Provider Name | Dr. Lewis Hogge |
First Address | Towson, MD 21204-2146 |
Second Address | Towson, MD 21204-6808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 07/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
456221600 | (05) | MD |
D0044584 | STATE LICENSE NUMBER (01) | MD |
E07611 | (02) | MD |