Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | 41229 | MD |
N | 2086S0120X | Pediatric Surgery | MD027246E | PA |
NPI | 1134107956 |
---|---|
Provider Name | Louis M Marmon |
First Address | Rockville, MD 20850-3320 |
Second Address | Rockville, MD 20850-3320 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 11/01/2022 |