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 | 207R00000X | Internal Medicine | | | | 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 | H888SH | OTHER | MARYLAND | BCBS OF ILLINOIS |
| 2 | 5327523 | OTHER | MARYLAND | AETNA ALL OTHERS |
| 3 | H888SH | OTHER | MARYLAND | BCBS CAREFIRST POS |
| 4 | H888 | MEDICARE PIN | MARYLAND | |
| 5 | 12998 | OTHER | MARYLAND | AETNA HMO SPECIALIST |
| 6 | 354ASH | OTHER | MARYLAND | BCBS CAREFIRST POS SPEC |
| 7 | 354ASH | OTHER | MARYLAND | BCBS MD SPECIALIST |
| 8 | 488609 | OTHER | MARYLAND | AETNA HMO |
| 9 | 354ASH | OTHER | MARYLAND | BCBS CAREFIRST TOWSON SPE |
| 10 | 3558 | OTHER | MARYLAND | BCBS DC FED |
| 11 | 8317462 | OTHER | MARYLAND | AETNA ALL OTHERS SPE |
| 12 | 463344 | MEDICARE PIN | DISTRICT OF COLUMBIA | |
| 13 | 3558 | OTHER | MARYLAND | BCBS CAREFIRST |
| 14 | CG9362 | OTHER | MARYLAND | MEDICARE RAILROAD |
| 15 | H888SH | OTHER | MARYLAND | BCBS MD |
| 16 | H888SH | OTHER | MARYLAND | BCSB CAREFIRST TOWSON |
