Individual
VILMA FONDEVILLA TADALAN-VELASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
80 KIRKS MILL LN, NORTH EAST, MD 21901-1712
(702) 430-8881
Mailing address
80 KIRKS MILL LN, NORTH EAST, MD 21901-1712
(702) 430-8881
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D0014635
MD
Other
Enumeration date
01/03/2010
Last updated
01/03/2010
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