Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | D0016632 | MD |
N | 2080P0210X | Pediatric Nephrologist | D0016632 | MD |
NPI | 1366425878 |
---|---|
Provider Name | Dr. Saul David Roskes |
First Address | Lutherville, MD 21093-4595 |
Second Address | Lutherville, MD 21093-4591 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 01/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D75326 | (02) | MD |