Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | DC6104 | DC |
NPI | 1396779310 |
---|---|
Provider Name | Thomas C Havell |
First Address | Baltimore, MD 21211-2803 |
Second Address | Washington, DC 20016-2618 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 09/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
110239370 | RAILROAD MEDICARE (01) | DC |
C61833 | (02) | DC |