Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | D0058600 | MD |
NPI | 1023005915 |
---|---|
Provider Name | Robert Knox |
First Address | Silver Spring, MD 20910-1459 |
Second Address | Silver Spring, MD 20910-1459 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2005 |
Last Update Date | 28/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
403587900 | (05) | MD |
G80813 | (02) | MD |