Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 4957 | DC |
NPI | 1568470938 |
---|---|
Provider Name | Dr. Robert William Emery |
First Address | Washington, DC 20037-1445 |
Second Address | Washington, DC 20037-1445 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 13/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U55987 | (02) |