Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | D0057808 | MD |
NPI | 1013192582 |
---|---|
Provider Name | Dr. Wiphada Patricia Bandettini |
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 | 03/01/2008 |
Last Update Date | 03/01/2008 |