Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 0101257603 | VA |
NPI | 1164664173 |
---|---|
Provider Name | Michael Quinn Potter |
First Address | Baltimore, MD 21279-0777 |
Second Address | Charlottesville, VA 22911-5639 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2009 |
Last Update Date | 30/11/2016 |