Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | MD5889 | MD |
NPI | 1093818197 |
---|---|
Provider Name | George Delgado |
First Address | Baltimore, MD 21228-1317 |
Second Address | Baltimore, MD 21228-1317 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 26/05/2016 |