Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 000918 | MD |
Y | 222Z00000X | Podiatrist | 000918 | MD |
NPI | 1003908179 |
---|---|
Provider Name | Dr. Michael Lloyd Gittleson |
First Address | Chevy Chase, MD 20815 |
Second Address | Chevy Chase, MD 20815 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2006 |
Last Update Date | 13/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02399200-01 | DME (01) | MD |
T31032 | (02) |