Individual
MASARU ISHII
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,PH.D.
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-2368
Mailing address
PO BOX 64588, BALTIMORE, MD 21264-4588
(410) 550-0460
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
D59315
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
384050600
—
MD
Enumeration date
05/25/2006
Last updated
02/08/2013
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