Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | D64852 | MD |
NPI | 1043385180 |
---|---|
Provider Name | Dr. Ravin Jain Garg |
First Address | Belfast, ME 04915-4017 |
Second Address | Annapolis, MD 21401-3093 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2006 |
Last Update Date | 05/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
011815000 | (05) | MD |