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Individual

ATIF KIDWAI JENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1447 YORK RD, SUITE 100, LUTHERVILLE, MD 21093-6017
(908) 528-2270
Mailing address
1447 YORK RD, SUITE 100, LUTHERVILLE, MD 21093-6017
(908) 528-2270

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
250130
MA
207R00000X
Internal Medicine Physician
A108255
CA
207RN0300X
Nephrology Physician
Primary
250130
MA

Other

Enumeration date
04/17/2007
Last updated
12/17/2021
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