Individual
ANGELA MANTZAVINOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
100 PARK AVE, BALTIMORE, MD 21201-3416
(410) 727-0285
Mailing address
9360 READER LN, COLUMBIA, MD 21045-3922
(443) 567-1047
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TA2926
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/19/2023
Last updated
07/11/2023
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