Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | D0019507 | MD |
NPI | 1245343375 |
---|---|
Provider Name | Ms. Kalavati J Dave |
First Address | Laurel, MD 20707-4830 |
Second Address | Laurel, MD 20707-4830 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
988911600 | (05) | MD |
DO9373 | (02) | MD |