Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | D77920 | MD |
Y | 208600000X | Surgeon | D77920 | MD |
NPI | 1013235084 |
---|---|
Provider Name | Josue Alvarez Casas |
First Address | Baltimore, MD 21201-1504 |
Second Address | Baltimore, MD 21201-1504 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2010 |
Last Update Date | 04/06/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D77920 | STATE OF MARYLAND (01) | MD |