Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | D31679 | MD |
NPI | 1083663165 |
---|---|
Provider Name | Dr. Michael S Donnenberg |
First Address | Baltimore, MD 21264-4442 |
Second Address | Baltimore, MD 21201-1544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2006 |
Last Update Date | 15/11/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
021036600 | (05) | WV |
034939700 | (05) | DC |
1083663165 | (05) | MD |
366101600 | (05) | MD |
B69284 | (02) | MD |