Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | D0083247 | MD |
NPI | 1013208032 |
---|---|
Provider Name | Linda Evonne Brogdon |
First Address | Damascus, MD 20872-1899 |
Second Address | Damascus, MD 20872-1899 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2011 |
Last Update Date | 14/06/2017 |