Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | D03778 | MD |
NPI | 1689605438 |
---|---|
Provider Name | Edward Sills |
First Address | Baltimore, MD 21264-4316 |
Second Address | Baltimore, MD 21287-0006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
711601200 | (05) | MD |
C57785 | (02) | MD |