Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | MD045759 | DC |
NPI | 1538422753 |
---|---|
Provider Name | Dr. Theodore Epaminondas Trigylidas |
First Address | Baltimore, MD 21297-3215 |
Second Address | Washington, DC 20010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2012 |
Last Update Date | 22/05/2018 |