Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | D24924 | MD |
NPI | 1740272301 |
---|---|
Provider Name | Ritchie Carr Shoemaker |
First Address | Pocomoke, MD 21851-1170 |
Second Address | Pocomoke, MD 21851-1170 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D77284 | (02) | MD |