Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | D44706 | MD |
N | 2084N0402X | Child Neurologist | 55982 | MN |
Y | 2084N0402X | Child Neurologist | D44706 | MD |
NPI | 1386686467 |
---|---|
Provider Name | Gerald V Raymond |
First Address | Baltimore, MD 21236-4902 |
Second Address | Baltimore, MD 21287-0005 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 10/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0016786000004 | (05) | PA |
046651400 | (05) | MD |
E65750 | (02) | MD |