Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | M38081 | MD |
NPI | 1083616601 |
---|---|
Provider Name | Scott E Andochick |
First Address | Frederick, MD 21702-4348 |
Second Address | Frederick, MD 21702-4348 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2005 |
Last Update Date | 19/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F18275 | (02) | MD |