Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 10572 | MD |
N | 1223P0106X | Oral and Maxillofacial Pathology | DS025429L | PA |
NPI | 1598735003 |
---|---|
Provider Name | Dr. Paul C. Shick |
First Address | Baltimore, MD 21264-4252 |
Second Address | Baltimore, MD 21287-0005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 10/10/2013 |