Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | D0042821 | MD |
NPI | 1124088398 |
---|---|
Provider Name | Melinda J Elliott |
First Address | Reisterstown, MD 21136-3529 |
Second Address | Baltimore, MD 21215-5216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D82529 | (02) |