Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | D0061306 | MD |
N | 207XS0106X | Orthopaedic Hand Surgeon | D0061306 | MD |
N | 207XS0106X | Orthopaedic Hand Surgeon | D0661306 | MD |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | D0061306 | MD |
NPI | 1295719805 |
---|---|
Provider Name | Joseph A Shrout |
First Address | Potomac, MD 20854-1556 |
Second Address | Rockville, MD 20850-6477 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2005 |
Last Update Date | 08/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I72050 | (02) | MD |