Individual
MR. NATHAN W KOLLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
500 UPPER CHESAPEAKE DR, BEL AIR, MD 21014-4324
(443) 643-1500
(443) 643-1505
Mailing address
500 UPPER CHESAPEAKE DR, BEL AIR, MD 21014-4324
(443) 643-1500
(443) 643-1505
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C0004217
MD
363A00000X
Physician Assistant
Primary
MA064644
PA
Other
Enumeration date
08/11/2010
Last updated
03/13/2024
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