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 | 207VB0002X | Obstetrics & Gynecology | Obesity Medicine | | | No |
| 2 | 207RB0002X | Internal Medicine | Obesity Medicine | | | No |
| 3 | 2083B0002X | Preventive Medicine | Obesity Medicine | | | No |
| 4 | 2083P0500X | Preventive Medicine | Preventive Medicine/Occupational Environmental Medicine | | | No |
| 5 | 207RE0101X | Internal Medicine | Endocrinology, Diabetes & Metabolism | | | No |
| 6 | 2083P0901X | Preventive Medicine | Public Health & General Preventive Medicine | | | No |
| 7 | 2083S0010X | Preventive Medicine | Sports Medicine | | | No |
| 8 | 103TC0700X | Psychologist | Clinical | | | No |
| 9 | 207PS0010X | Emergency Medicine | Sports Medicine | | | No |
| 10 | 2083T0002X | Preventive Medicine | Medical Toxicology | | | No |
| 11 | 2084P0800X | Psychiatry & Neurology | Psychiatry | | | No |
| 12 | 363LF0000X | Nurse Practitioner | Family | | | No |
| 13 | 363LP0808X | Nurse Practitioner | Psychiatric/Mental Health | | | No |
| 14 | 363LP2300X | Nurse Practitioner | Primary Care | | | No |
| 15 | 208D00000X | General Practice | | | | Yes |
