Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | A66254 | CA |
Y | 207SG0201X | Clinical Genetics (M.D.) | MD044822 | DC |
NPI | 1275557423 |
---|---|
Provider Name | Eric Jean Nicolas Vilain |
First Address | Baltimore, MD 21297-3215 |
Second Address | Washington, DC 20010-2916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A662540 | (05) | CA |
G81944 | (02) | CA |
GR0053510 | (05) | CA |