Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | Q3944 | TX |
Y | 207WX0107X | Retina Specialist | D0084732 | MD |
NPI | 1003105677 |
---|---|
Provider Name | Erwin Calvo Puente |
First Address | Bethesda, MD 20817-1842 |
Second Address | Bethesda, MD 20817-1888 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2011 |
Last Update Date | 03/12/2019 |