Individual
MARIANNE RALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
501 W 7TH ST, FREDERICK, MD 21701
(301) 698-8374
(240) 439-8910
Mailing address
PO BOX 37086, BALTIMORE, MD 21297-3086
(240) 439-8913
(240) 439-8910
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
C0001065
MD
363AM0700X
Medical Physician Assistant
Primary
C01065
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
762671100
—
MD
Enumeration date
06/28/2006
Last updated
07/30/2019
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