Individual
FATOUMATA TAMADOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4625 HORIZON CIR APT 102, PIKESVILLE, MD 21208-6801
(443) 616-7218
Mailing address
4625 HORIZON CIR APT 102, PIKESVILLE, MD 21208-6801
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
R4330
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
83-1062282
LEVEL 1
MD
05
—
83-1062282
—
MD
Enumeration date
03/12/2020
Last updated
03/12/2020
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