Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | MD22159 | DC |
N | 208000000X | Pediatrician | MD22159 | DC |
NPI | 1477783009 |
---|---|
Provider Name | Dr. Wendy Jewell Introne |
First Address | Bethesda, MD 20892-0001 |
Second Address | Bethesda, MD 20892-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2009 |
Last Update Date | 16/07/2009 |