Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | D0063068 | MD |
N | 2080P0208X | Pediatric Infectious Diseases | D0063068 | MD |
NPI | 1467417527 |
---|---|
Provider Name | Patrick Jean-Philippe |
First Address | Clinton, MD 20735-3372 |
Second Address | Clinton, MD 20735-3372 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 31/08/2011 |