Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | D61583 | MD |
NPI | 1215972385 |
---|---|
Provider Name | Nicole A Shilkofski |
First Address | Baltimore, MD 21209-4233 |
Second Address | Baltimore, MD 21287-0010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 29/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
405249800 | (05) | MD |
I21916 | (02) |