Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | D0082884 | MD |
NPI | 1033409362 |
---|---|
Provider Name | Grice Shelton Mcmullan |
First Address | Baltimore, MD 21237-3901 |
Second Address | Baltimore, MD 21237-3901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2011 |
Last Update Date | 30/08/2021 |