Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | D88226 | MD |
N | 207RX0202X | Medical Oncology | D88226 | MD |
NPI | 1053502245 |
---|---|
Provider Name | Sandra Liliana Pedraza Cardozo |
First Address | Baltimore, MD 21236-4902 |
Second Address | Washington, DC 20016-2633 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2007 |
Last Update Date | 04/11/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3810024568 | (05) | WV |
4653868780 | MYUTMB 4653868780 (01) | |
D88226 | LICENSE (01) | MD |
PENDING | (05) | OH |
WV2315A | (02) |