Individual
INGRID MAZIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8957 EDMONSTON RD, SUITE J, GREENBELT, MD 20770-1005
(301) 313-8700
(301) 313-8704
Mailing address
8957 EDMONSTON RD, SUITE J, GREENBELT, MD 20770-1005
(301) 313-8700
(301) 313-8704
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD17765
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064981300
—
MD
Enumeration date
06/27/2006
Last updated
10/20/2011
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