Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD034456 | DC |
NPI | 1013988229 |
---|---|
Provider Name | Dr. Menachem Miodovnik |
First Address | Washington, DC 20007-1912 |
Second Address | Washington, DC 20010-2976 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 22/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010082587 | (05) | DC |
035718900 | (05) | DC |
405009600 | (05) | DC |
A79305 | (02) | DC |