Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | D0020099 | MD |
N | 207R00000X | Internist | D0020099 | MD |
N | 111NI0900X | Internist | D0020099 | MD |
N | 208D00000X | General Practice Physician | D0020099 | MD |
NPI | 1124099163 |
---|---|
Provider Name | Franklin J Addison |
First Address | Ellicott City, MD 21042-1106 |
Second Address | Baltimore, MD 21217-3940 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2006 |
Last Update Date | 11/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B68056 | (02) | MD |