Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP3567 | AZ |
NPI | 1003148495 |
---|---|
Provider Name | Mr. Robert M. Ginsburg |
First Address | Middletown, DE 19709-4021 |
Second Address | Germantown, MD 20876-7103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2010 |
Last Update Date | 06/11/2015 |