Individual
MRS. MODUPE V AGUEH MCCRACKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., MPH
Contact information
Practice address
10755 FALLS RD, SUITE 420, LUTHERVILLE, MD 21093-4515
(443) 997-0400
(410) 583-2756
Mailing address
600 N. WOLFE STREET, PHIPPS 254, BALTIMORE, MD 21287
(410) 955-9045
(410) 502-5505
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
D077211
MD
Other
Enumeration date
04/15/2009
Last updated
11/12/2015
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