Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | D70310 | MD |
Y | 207RX0202X | Medical Oncology | D70310 | MD |
NPI | 1104035971 |
---|---|
Provider Name | Sandy Diana Kotiah |
First Address | Baltimore, MD 21202 |
Second Address | Baltimore, MD 21202-2102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 02/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
032664000 | (05) | MD |
9754/0117 | CAREFIRST (01) | MD |