Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | D41017 | MD |
N | 207VX0000X | Obstetrician | D41017 | MD |
NPI | 1376638213 |
---|---|
Provider Name | Dr. Taro John Adachi |
First Address | Baltimore, MD 21215-5224 |
Second Address | Baltimore, MD 21215-5224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 29/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0233779006 | CIGNA (01) | |
107649 | COVENTRY (01) | |
4604839 | AETNA (01) | |
533865 | ALLIANCE (01) | |
533865 | MAMSI OPT CHOICE MDIA (01) | |
589081100 | (05) | MD |
DA67TJ | BCBS (01) | |
F69302 | (02) |