Individual
ETHAN SAMUEL SRINIVASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1800 ORLEANS ST DEPARTMENT OF NEUROSURGERY, ZAYED TOWER, MAILSTOP 6007, BALTIMORE, MD 21287-0010
(443) 286-3549
Mailing address
1800 ORLEANS ST DEPARTMENT OF NEUROSURGERY, ZAYED TOWER, MAILSTOP 6007, BALTIMORE, MD 21287-0010
(443) 286-3549
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/23/2022
Last updated
03/23/2022
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