Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | D74548 | MD |
NPI | 1013100049 |
---|---|
Provider Name | Sarah Nakib |
First Address | Baltimore, MD 21264-4252 |
Second Address | Baltimore, MD 21287-0006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2007 |
Last Update Date | 01/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
056886400 | (05) | MD |