Individual
JACKSON T TSAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5755 CEDAR LN, COLUMBIA, MD 21044-2912
(410) 910-3303
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-4380
(410) 706-5103
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
D53896
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022004300
—
MD
05
—
203001200
—
MD
Enumeration date
07/11/2006
Last updated
03/31/2023
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