Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0120X | Pediatric Surgery | MD12302 | DC |
NPI | 1063502524 |
---|---|
Provider Name | Martin Eichelberger |
First Address | Washington, DC 20010-2978 |
Second Address | Washington, DC 20010-2978 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E69214 | (02) |