Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 0101043436 | VA |
N | 2080N0001X | Neonatal-Perinatal Doctor | 0101043436 | VA |
NPI | 1003861709 |
---|---|
Provider Name | Phyllis R. Hope |
First Address | Baltimore, MD 21279-0137 |
Second Address | Norfolk, VA 23507-1910 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 09/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006734553 | (05) | VA |
8913094 | (05) | NC |
H04917 | (02) |