Individual
MR. TYLER JAMES CORKUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
120 BANJO LN, CENTREVILLE, MD 21617-1002
(410) 758-2211
Mailing address
5304 PURLINGTON WAY, BALTIMORE, MD 21212-3403
(443) 845-2512
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R217257
MD
Other
Enumeration date
05/28/2018
Last updated
05/23/2024
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