Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist |
NPI | 1174718217 |
---|---|
Provider Name | Mr. Gregory Scott Sachs |
First Address | Baldwin, MD 21013-9205 |
Second Address | Parkville, MD 21234-2450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2007 |
Last Update Date | 12/09/2007 |