Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | D23747 | MD |
NPI | 1013099837 |
---|---|
Provider Name | John Harold Lossing |
First Address | Annapolis, MD 21401-3046 |
Second Address | Annapolis, MD 21401-3046 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2006 |
Last Update Date | 09/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
144547ZCP1 | MEDICARE PROVIDER GROUP MEMBER PTAN (01) | MD |