Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | D 08663 | MD |
NPI | 1477557379 |
---|---|
Provider Name | Dr. Martin Douglas Valentine |
First Address | Pikesville, MD 21208-1038 |
Second Address | Pikesville, MD 21208-1038 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2005 |
Last Update Date | 11/05/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B66925 | (02) | MD |