Im, Dwight D
Im, Dwight D is an individual health care provider with primary practice located at 227 St. Paul Place 6Th Floor, Baltimore MD 21202-2102. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecologic Oncology, which is considered as his primary health care specialty. Im, Dwight D can be contacted via phone (410) 332-9002.Contact Information
Primary practice address
227 St. Paul Place 6Th Floor
Baltimore MD 21202-2102
Phone: (410) 332-9002
Fax: (410) 783-5880
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gynecologic Oncology | 207VX0201X | D0043934 | Maryland |
Profile Details
| NPI number | 1770521130 |
|---|---|
| LBN Legal business name | Im, Dwight D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 4th, 2006 |
| Last updated | Mar 26th, 2014 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770521130 | NPPES |
| Maryland | Other | S186 / 0013 | BLUECHOICE |
| Maryland | Other | KT93ST / 528170-06 | BLUECHOICE |
| Maryland | MEDICAID | 447571200 | BLUECHOICE |
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