Individual
JULIAN BOODRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6116 BELAIR RD, BALTIMORE, MD 21206-1927
(410) 426-1424
Mailing address
5602 CARRINGTON DR, WHITE MARSH, MD 21162-1122
(202) 390-2118
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
24139
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000
N/A
—
Enumeration date
08/05/2019
Last updated
08/05/2019
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