Individual
LIA PENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-0100
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6423
(410) 500-4266
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
D0098675
MD
Other
Enumeration date
04/15/2020
Last updated
05/30/2024
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