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Individual

MRS. HAELEE DUREN PETTINGILL COHEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
345 SAINT PAUL ST, BALTIMORE, MD 21202-2123
(410) 332-9000
Mailing address
12014 WATERSIDE VIEW DR APT 14, RESTON, VA 20194-1758

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110-007722
VA
363A00000X
Physician Assistant
Primary
C0007927
MD

Other

Enumeration date
02/09/2020
Last updated
11/08/2021
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