Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 6914 | MD |
Y | 208600000X | Surgeon | 6914 | MD |
NPI | 1003378498 |
---|---|
Provider Name | Georgios Antonios Margonis |
First Address | Baltimore, MD 21287 |
Second Address | Baltimore, MD 21287 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2019 |
Last Update Date | 03/04/2019 |