Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | D0026746 | MD |
N | 208000000X | Pediatrician | D0026746 | MD |
NPI | 1568693331 |
---|---|
Provider Name | Dr. Susan Roseanne Panny |
First Address | Hunt Valley, MD 21030-2054 |
Second Address | Baltimore, MD 21201-2301 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2009 |
Last Update Date | 28/07/2009 |