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 | 207ND0101X | Dermatology | MOHS-Micrographic Surgery | | | No |
2 | 207R00000X | Internal Medicine | | | | No |
3 | 207RC0000X | Internal Medicine | Cardiovascular Disease | | | No |
4 | 207RE0101X | Internal Medicine | Endocrinology, Diabetes & Metabolism | | | No |
5 | 207VG0400X | Obstetrics & Gynecology | Gynecology | | | No |
6 | 208100000X | Physical Medicine & Rehabilitation | | | | No |
7 | 2084N0400X | Psychiatry & Neurology | Neurology | | | No |
8 | 2085R0202X | Radiology | Diagnostic Radiology | | | No |
9 | 2085R0204X | Radiology | Vascular & Interventional Radiology | | | No |
10 | 213ES0103X | Podiatrist | Foot & Ankle Surgery | | | No |
11 | 261QP2000X | Clinic/Center | Physical Therapy | | | No |
12 | 261QR0200X | Clinic/Center | Radiology | | | No |
13 | 291U00000X | Clinical Medical Laboratory | | | | No |
14 | 363LW0102X | Nurse Practitioner | Women's Health | | | No |
15 | 207Q00000X | Family Medicine | | | | Yes |