Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 01107 | MD |
Y | 222Z00000X | Podiatrist | 01107 | MD |
NPI | 1003926122 |
---|---|
Provider Name | Dr. Michael Tritto |
First Address | Rockville, MD 20850-1341 |
Second Address | Rockville, MD 20852-2734 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 27/11/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
781918801 | (05) | MD |
U24216 | (02) | MD |