Individual
JUDY M DESTOUET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7253 AMBASSADOR RD, BALTIMORE, MD 21244-2710
(443) 436-1151
(443) 436-1256
Mailing address
7253 AMBASSADOR RD, BALTIMORE, MD 21244-2710
(443) 436-1151
(443) 436-1256
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D0043704
MH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
182991200
—
MD
Enumeration date
06/27/2006
Last updated
01/15/2014
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