Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | D0015271 | MD |
NPI | 1134121023 |
---|---|
Provider Name | Johnny T Yap |
First Address | Baltimore, MD 21229-1024 |
Second Address | Baltimore, MD 21229-1024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 02/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
026291900 | (05) | MD |
9436JT | CAREFIRST BLUE SHIELD (01) | MD |
D76614 | (02) |