Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 02164910 | MD |
NPI | 1124249818 |
---|---|
Provider Name | Mr. F. Nicholas Codd |
First Address | Severna Park, MD 21146-0627 |
Second Address | Severna Park, MD 21146-3979 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 09/07/2008 |