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First Name: Last Name: Gender: Female Male Non-binary/gender non-conforming Prefer Not to Answer Title: Subspecialty: Institution: Albany Medical Center Albert Einstein College of Medicine Barabara Zucker School of Medicine at Hofstra/Northwell Baylor College of Medicine Baystate Children's Hospital Boston University School of Medicine Brown University Case Western Reserve University School of Medicine Central Michigan University College of Medicine Chicago Medical School at Rosalind Franklin University Children's Mercy Kansas City Cleveland Clinic Columbia University Vagelos College of Physicians & Surgeons Creighton Medical School, Phoenix Creighton University School of Medicine Dalhousie University Dell Medical School at the University of Texas at Austin Drexel University College of Medicine Duke University School of Medicine East Carolina University Brody School of Medicine East Tennessee State University Eastern Virginia Medical School Emory University School of Medicine Florida International University Herbert Wertheim College of Medicine Geisel School of Medicine at Dartmouth George Washington University School of Medicine Georgetown University School of Medicine Hackensack Meridian School of Medicine at Seton Hall Harvard Medical School, Children's Hospital Harvard Medical School, Massachusetts Gen. Hospital Howard University College of Medicine Indiana University School of Medicine Johns Hopkins University School of Medicine Kansas University Medical Center Keck School of Medicine of the University of Southern California Loma Linda University School of Medicine Louisiana State University School of Medicine in New Orleans Louisiana State University School of Medicine in Shreveport Loyola University Chicago Stritch School of Medicine Marshall University Joan C. Edwards School of Medicine Mayo Medical School McGill University McMaster University Medical College of Georgia at Augusta University Medical College of Wisconsin Medical University of South Carolina College of Medicine Meharry Medical College Memorial University Newfoundland Mercer University School of Medicine Michigan State University College of Medicine Morehouse School of Medicine Mount Sinai School of Medicine New York Medical College New York University School of Medicine Northeast Ohio Medical University Northwestern University The Feinberg School of Medicine Oakland University William Beaumont School of Medicine Ohio State University College of Medicine Oregon Health and Science University School of Medicine Pennsylvania State University College of Medicine Ponce School of Medicine and Health Sciences Queens University Rush Medical College of Rush University Medical Center Rutgers New Jersey Medical School Rutgers Robert Wood Johnson Medical School Saint Louis University School of Medicine Sanford School of Medicine The University of South Dakota Sidney Kimmel Medical College at Thomas Jefferson University Southern Illinois University Stanford University School of Medicine SUNY Downstate Medical Center College of Medicine SUNY Upstate Medical University Temple University School of Medicine Texas A&M Health Science Center College of Medicine Texas Christian University and University of North Texas School of Medicine Texas Tech University Health Sciences Center School of Medicine Texas Tech University, Paul L. Foster School of Medicine The Barbara Bush Children's Hospital at Maine Medical Center The Brody School of Medicine at East Carolina University The School of Medicine at Stony Brook University Medical Center The University of Texas School of Medicine at San Antonio Tufts University School of Medicine Tulane University School of Medicine Uniformed Services University of Health Sciences University at Buffalo SUNY School of Medicine and Biomedical Sciences University of Alabama School of Medicine University of Alberta University of Arizona College of Medicine University of Arkansas for Medical Sciences College of Medicine University of British Columbia University of Calgary University of California, Davis, School of Medicine University of California, Irvine, School of Medicine University of California, Los Angeles David Geffen School of Medicine University of California, San Diego School of Medicine University of California, San Francisco, School of Medicine University of Chicago The Pritzker School of Medicine University of Cincinnati College of Medicine University of Colorado School of Medicine University of Connecticut School of Medicine University of Florida - Jacksonville University of Florida College of Medicine University of Hawaii, John A. Burns School of Medicine University of Illinois College of Medicine University of Illinois, Peoria School of Medicine University of Illinois, Rockford School of Medicine University of Iowa Carver College of Medicine University of Kansas, Wichita School of Medicine University of Kentucky College of Medicine University of Louisville School of Medicine University of Manitoba University of Maryland School of Medicine University of Massachusetts Medical School University of Miami Leonard M. Miller School of Medicine University of Michigan Medical School University of Minnesota Masonic Children's Hospital University of Mississippi School of Medicine University of Missouri - Kansas City School of Medicine University of Missouri-Columbia School of Medicine University of Nebraska College of Medicine University of Nevada - Las Vegas School of Medicine University of Nevada-Reno School of Medicine University of New Mexico School of Medicine University of North Carolina at Chapel Hill School of Medicine University of North Dakota School of Medicine and Health Sciences University of Oklahoma College of Medicine University of Oklahoma, Tulsa School of Medicine University of Ottawa University of Pennsylvania School of Medicine University of Pittsburgh School of Medicine University of Puerto Rico School of Medicine University of Rochester School of Medicine and Dentistry University of Saskatchewan University of South Alabama College of Medicine University of South Carolina School of Medicine University of South Carolina School of Medicine Greenville University of South Florida College of Medicine University of Tennessee College of Medicine, Chattanooga Campus University of Tennessee Health Science Center College of Medicine University of Texas Medical Branch School of Medicine University of Texas Medical School at Houston University of Texas Rio Grande School of Medicine University of Texas Southwestern Medical Center, Dallas University of Toledo College of Medicine University of Toronto University of Utah School of Medicine University of Vermont Larner College of Medicine University of Virginia School of Medicine University of Washington School of Medicine University of Western Ontario University of Wisconsin School of Medicine and Public Health Vanderbilt University School of Medicine Virginia Commonwealth University School of Medicine Virginia Tech Carilion School of Medicine Wake Forest University School of Medicine Washington University in St. Louis School of Medicine Wayne State University School of Medicine Weill Cornell University School of Medicine West Virginia University School of Medicine Western Michigan University School of Medicine Winthrop University Hospital Wright State University Boonshoft School of Medicine Yale University School of Medicine Degrees: Member Type Chair Interim Chair Administrator Prospective Former Chair Deceased FIS Resident Other PLDP Fellow PLDP Applicant Emeritus Chair Hired From Within No Yes Date Chair Started: Program Size: Email: Phone: Fax: Address: Address Line 2 Address Line 3 City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming American Samoa Federated States of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico U.S. Minor Outlying Islands Virgin Islands Armed Forces Americas Armed Forces Europe, the Middle East, an Armed Forces Pacific Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Territory Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory Zip: - Zip Suffix Facebook Handle: Twitter Handle: LinkedIn Handle: Assistant's First Name: Assistant's Last Name: Assistant's Email: Assistant's Phone Number: Captcha