Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | D0028380 | MD |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | D0028380 | MD |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | D0028380 | MD |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | D0028380 | MD |
NPI | 1386687812 |
---|---|
Provider Name | Mark S Myerson |
First Address | Baltimore, MD 21264-4075 |
Second Address | Baltimore, MD 21202-2102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2006 |
Last Update Date | 25/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
431901000 | (05) | MD |
D76773 | (02) | |
F730 / 0001 | BLUECHOICE (01) | MD |
KBM7 / 350529-09 | BC / BS OF MD (01) | MD |