Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | D61646 | MD |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | D61646 | MD |
N | 207RI0011X | Interventional Cardiology | D61646 | MD |
NPI | 1154379774 |
---|---|
Provider Name | Dr. Timm-Michael Dickfeld |
First Address | Baltimore, MD 21264-4442 |
Second Address | Baltimore, MD 21201-1544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 28/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
037161400 | (05) | DC |
405841100 | (05) | MD |
644039-01 | BLUE CROSS/BLUE SHIELD (01) | MD |
I19631 | (02) | MD |