Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD040612 | DC |
Y | 2080A0000X | Adolescent Medicine | MD040612 | DC |
NPI | 1275761504 |
---|---|
Provider Name | Dr. Sharyn Malcolm |
First Address | Washington, DC 20010 |
Second Address | Washington, DC 20010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2009 |
Last Update Date | 16/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
MD040612 | MEDICAL LICENSE (01) | DC |