Individual
JEPHTHAH ASIMOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 WEST RD STE 300, TOWSON, MD 21204-2370
(443) 431-0618
Mailing address
21 TREEWAY CT APT 2C, TOWSON, MD 21286-3489
(443) 431-0618
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
MT0147808
MD
Other
Enumeration date
04/07/2025
Last updated
04/07/2025
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