Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | D32629 | MD |
NPI | 1063477917 |
---|---|
Provider Name | Garrett John Lynch |
First Address | Annapolis, MD 21401-3088 |
Second Address | Annapolis, MD 21401-3088 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D76761 | (02) | MD |