Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 0101238650 | VA |
Y | 207PP0204X | Pediatric Emergency Physician | MD036806 | DC |
NPI | 1366482275 |
---|---|
Provider Name | Mr. Jamal Ahmad Rana |
First Address | Baltimore, MD 21297-3215 |
Second Address | Washington, DC 20010-2978 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 15/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010256283 | (05) | VA |
1366482275 | (05) | VA |
G47146 | (02) |