Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | BP10046658 | TX |
Y | 111NI0900X | Internist | BP10046658 | TX |
N | 207RA0201X | Internist - Allergy & Immunology | MD045198 | DC |
NPI | 1881038107 |
---|---|
Provider Name | Gregory Constantine |
First Address | Bethesda, MD 20814 |
Second Address | Bethesda, MD 20814 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2013 |
Last Update Date | 11/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
574136 | TEXAS MEDICAL BOARD (01) | TX |
MD045198 | DC HEALTH (01) | DC |