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Individual

SUSAN MABROUK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1800 ORLEANS ST, BALTIMORE, MD 21287-0010
(410) 955-6154
Mailing address
1800 ORLEANS ST, BALTIMORE, MD 21287-0010
(410) 955-6154

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0116019438
VA
208000000X
Pediatrics Physician
Primary
D70788
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
035464300
MD
Enumeration date
04/30/2008
Last updated
10/28/2013
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