Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | D18895 | MD |
NPI | 1023010022 |
---|---|
Provider Name | Mr. Mobarak Karim |
First Address | Takoma Park, MD 20912-6384 |
Second Address | Takoma Park, MD 20912-6384 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 08/07/2007 |