Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 207RR0500X | Internal Medicine | Rheumatology | D0043663 | MARYLAND | No |
| 2 | 207RR0500X | Internal Medicine | Rheumatology | MD11903 | DISTRICT OF COLUMBIA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 521444579 0001 | OTHER | | CIGNA |
| 2 | 413915 | MEDICARE PIN | DISTRICT OF COLUMBIA | |
| 3 | 0004053756 | OTHER | | AETNA |
| 4 | 0762 | OTHER | | BLUE CROSS BLUE SHIELD |
| 5 | 521444579 | OTHER | | NCPPO |
| 6 | 0735441 | OTHER | | AETNA |
| 7 | 000783612 | OTHER | | AMERICAN POSTAL WORKERS |
| 8 | 105547 | OTHER | | AMERIGROUP |
| 9 | 010017400 | MEDICAID | DISTRICT OF COLUMBIA | |
| 10 | 580P0762410001 | OTHER | | CAREFIRST NATIONAL ACCOUN |
| 11 | 521444579 20010 A001 | OTHER | | TRICARE |
| 12 | 521444579 | OTHER | | MAILHANDLERS |
| 13 | 521444579 | OTHER | | VERIZON |
| 14 | 521444579 | OTHER | | UNITED HEALTHCARE |
| 15 | H06833 | MEDICARE UPIN | | |
| 16 | 521444579 | OTHER | | KAISER |
