Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | D29940 | MD |
Y | 207RA0201X | Internist - Allergy & Immunology | D29940 | MD |
NPI | 1225275456 |
---|---|
Provider Name | Dr. Thomas Bruce Nutman |
First Address | Bethesda, MD 20892-0425 |
Second Address | Bethesda, MD 20892-0425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2009 |
Last Update Date | 09/01/2009 |