Individual
DR. MARIAILEEN SOURWINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
277 PENINSULA FARM RD STE I, ARNOLD, MD 21012-1018
(410) 989-8833
(410) 975-5641
Mailing address
277 PENINSULA FARM RD STE I, ARNOLD, MD 21012-1018
(410) 989-8833
(410) 975-5641
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D72591
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D72591
MARYLAND STATE LICENSE
MD
Enumeration date
06/06/2008
Last updated
12/07/2021
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