Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 02013 | MD |
Y | 103T00000X | Psychologist | 02013 | MD |
NPI | 1003963562 |
---|---|
Provider Name | Mr. David W Schrumpf |
First Address | Fallston, MD 21047-2737 |
Second Address | Fallston, MD 21047-2737 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2007 |
Last Update Date | 08/07/2007 |