Individual
SANDRA MARIA QUEZADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22 S GREENE ST, MEDICINE, N3E09, BALTIMORE, MD 21201-1544
(410) 706-3387
Mailing address
PO BOX 64442, N3E09, BALTIMORE, MD 21264-4442
(410) 706-3387
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
D76345
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
999911600
—
MD
01
—
S062-0527
CAREFIRST BC/BS
MD
Enumeration date
02/21/2007
Last updated
08/21/2014
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