Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | D0092368 | MD |
NPI | 1093128456 |
---|---|
Provider Name | John Anthonypillai |
First Address | Bel Air, MD 21015-6056 |
Second Address | Bel Air, MD 21015 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2014 |
Last Update Date | 01/10/2021 |