Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080A0000X | Adolescent Medicine | D0074672 | MD |
Y | 2080A0000X | Adolescent Medicine | MD 038304 | DC |
NPI | 1043403108 |
---|---|
Provider Name | Lisa Tuchman |
First Address | Washington, DC 20010-2916 |
Second Address | Washington, DC 20010-2916 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2007 |
Last Update Date | 03/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
027980100 | (05) | DC |