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 | 213ES0131X | Podiatrist | Foot Surgery | 01457 | MARYLAND | 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 | 7278 | OTHER | MARYLAND | BRAVO/ELDER HEALTH |
| 2 | 002XD | OTHER | MARYLAND | BLUE CROSS BLUE SHIELD OF MARYLAND |
| 3 | 415343000 | MEDICAID | MARYLAND | |
| 4 | 201922 | OTHER | MARYLAND | JOHN HOPKINS/PRIORITY PARTNERS/EMPLOYER HEALTH/UNIFORMED SERVICES FAMILY HEALTH |
| 5 | 9443167 | OTHER | MARYLAND | AETNA |
| 6 | P00645864 AND DN9160 | OTHER | MARYLAND | RAILROAD MEDICARE |
| 7 | D364 | OTHER | MARYLAND | BLUE CROSS BLUE SHIELD-GHMSI |
| 8 | 018750060 | OTHER | MARYLAND | MARYLAND PHYSICIAN CARE |
| 9 | 128704 | MEDICARE UPIN | MARYLAND | |
| 10 | 3175526 | OTHER | MARYLAND | UNITED HEALTH CARE |
| 11 | 6131880001 | MEDICARE NSC | MARYLAND | |
