Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | D0022019 | MD |
N | 111NI0900X | Internist | D0022019 | MD |
Y | 207RP1001X | Pulmonary Disease | D0022019 | MD |
NPI | 1033110028 |
---|---|
Provider Name | Mr. Lloyd E Halvorson |
First Address | Frederick, MD 21704-5236 |
Second Address | Frederick, MD 21704-5236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 18/07/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
317011000 | (05) | MD |
D74610 | (02) | |
D74610 | (02) | MD |