Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 8819 | MD |
NPI | 1285619700 |
---|---|
Provider Name | Dr. Robert Douglas Foss |
First Address | Baltimore, MD 21236-4902 |
Second Address | Baltimore, MD 21287-0010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2005 |
Last Update Date | 13/03/2019 |