Individual
KELLY ANNE IMPHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 ST. PAUL PLACE, DEPT. OF CARDIOLOGY, BALTIMORE, MD 21202-2102
(410) 332-9722
Mailing address
301 ST. PAUL PLACE, MEDICAL STAFF OFFICE, BALTIMORE, MD 21202-2102
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/15/2009
Last updated
09/15/2009
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