Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | D0061781 | MD |
NPI | 1568659464 |
---|---|
Provider Name | Ravinder Dahiya |
First Address | Chevy Chase, MD 20815-7003 |
Second Address | Chevy Chase, MD 20815-7003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2007 |
Last Update Date | 25/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D0061781 | STATE LICENSE (01) | MD |