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Individual

DR. DAVID PATRIC RASTALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO PHD

Contact information

Practice address
600 N WOLFE STREET PATHOLOGY 2210, BALTIMORE, MD 21264-1896
(410) 614-6302
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6423

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
5101024175
MI
2084N0400X
Neurology Physician
Primary
H95435
MD
2084N0400X
Neurology Physician
OS024179
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16223192
CAQH
Enumeration date
06/13/2018
Last updated
09/26/2024
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