Individual
DR. TIA RAGLAND MEDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5009 HONEYGO CENTER DR STE 225, PERRY HALL, MD 21128-9843
(443) 725-2100
(443) 725-2121
Mailing address
5009 HONEYGO CENTER DR STE 225, PERRY HALL, MD 21128-9843
(443) 725-2100
(443) 725-2121
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D64590
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010456600
—
MD
01
—
75859901
BLUE SHIELD
MD
Enumeration date
05/25/2006
Last updated
03/08/2019
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