Individual
DR. TARA M EASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2411 W BELVEDERE AVE STE 508, BALTIMORE, MD 21215-5232
(410) 601-8383
Mailing address
2411 W BELVEDERE AVE STE 508, BALTIMORE, MD 21215-5232
(410) 601-8383
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
38496
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64089337
—
KY
Enumeration date
06/03/2006
Last updated
05/01/2020
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