Individual
MR. ANTONIO L MCCAN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2120 KOKO LN, BALTIMORE, MD 21216-2924
(443) 392-7698
Mailing address
2120 KOKO LN, BALTIMORE, MD 21216-2924
(443) 392-7698
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
M250067485086
MD
Other
Enumeration date
05/02/2016
Last updated
05/02/2016
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