Individual
MS. JALIAH MATOVU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3559 BOSTON ST, BALTIMORE, MD 21224-5750
(410) 246-8516
Mailing address
3559 BOSTON ST, BALTIMORE, MD 21224-5750
(410) 246-8516
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R229717
MD
Other
Enumeration date
06/25/2021
Last updated
09/16/2021
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