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Individual

NICOLE BONSAVAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
6701 N CHARLES ST STE 1630, BALTIMORE, MD 21204-6808
(443) 849-4145
Mailing address
6701 N CHARLES ST STE 1630, TOWSON, MD 21204-6808
(443) 849-4145

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
D0098068
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
261601700
MD
Enumeration date
04/15/2019
Last updated
09/30/2024
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