Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 01666 | MD |
NPI | 1053769596 |
---|---|
Provider Name | Emmanuella Maria Eastman |
First Address | Rockville, MD 20850-1496 |
Second Address | Wheaton, MD 20902-1905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/05/2016 |
Last Update Date | 11/11/2019 |