Individual
CARRIE NIEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 N CAROLINE ST FL 6, BALTIMORE, MD 21287-0006
(410) 955-1686
Mailing address
601 N CAROLINE ST FL 6, BALTIMORE, MD 21287-0006
(410) 955-1686
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
N-550-108-564-396
MD
207Y00000X
Otolaryngology Physician
N550-1128-4750
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N-550-108-564-396
DRIVER'S LICENSE
MD
01
—
N550-1128-4750
STATE DRIVER LICENSE
IL
Enumeration date
04/06/2011
Last updated
07/07/2023
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