Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | P19152 | MD |
Y | 2080P0208X | Pediatric Infectious Diseases | D65975 | MD |
NPI | 1316090236 |
---|---|
Provider Name | Dr. Pranita D Tamma |
First Address | Baltimore, MD 21202-2649 |
Second Address | Baltimore, MD 21287-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 23/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
412900800 | (05) | MD |