Individual
MAMADOU SADIO DIALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
504 LEWIS ST, HAVRE DE GRACE, MD 21078-3420
(443) 502-5311
Mailing address
1344 TRALEE CIR, ABERDEEN, MD 21001-2642
(646) 260-6327
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R221648
MD
Other
Enumeration date
04/28/2021
Last updated
04/28/2021
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