Individual
MICHELLE MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 N WOLFE STREET, BLALOCK 439, BALTIMORE, MD 21287-0005
(410) 955-2636
(410) 614-8337
Mailing address
9910 FRANKLIN SQUARE DR STE 2110, BALTIMORE, MD 21236-4902
(410) 933-6423
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT203542
PA
207RG0100X
Gastroenterology Physician
Primary
D87558
MD
Other
Enumeration date
05/08/2013
Last updated
10/20/2019
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