Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RI0200X | Infectious Disease | D56258 | MD |
Y | 2080P0208X | Pediatric Infectious Diseases | D56258 | MD |
NPI | 1003851106 |
---|---|
Provider Name | Milagritos D Tapia |
First Address | Baltimore, MD 21264-2063 |
Second Address | Baltimore, MD 21201-1544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 07/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
403847900 | (05) | MD |
641056-01 | BLUE CROSS/BLUE SHIELD (01) | MD |
H98529 | (02) |