Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 34 | MD |
NPI | 1073653002 |
---|---|
Provider Name | Dr. Mary Elizabeth Aichelmann-Reidy |
First Address | Baltimore, MD 21201-1510 |
Second Address | Baltimore, MD 21201-1510 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 08/07/2007 |