Individual
BAO LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1748 MERRITT BLVD STE B, DUNDALK, MD 21222-3212
(443) 530-6381
Mailing address
301 TEMPLE CT, BEL AIR, MD 21015-6163
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA2863
MD
Other
Enumeration date
07/07/2022
Last updated
07/07/2022
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