Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | D0056669 | MD |
N | 2081P2900X | Pain Medicine | D0056669 | MD |
NPI | 1073556353 |
---|---|
Provider Name | Dr. Ross Sugar |
First Address | Baltimore, MD 21209-4354 |
Second Address | Baltimore, MD 21209-4354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 10/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
408209500 | (05) | MD |
H38247 | (02) | MD |