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Individual

ELIJAH THOMSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
9708 LANGLEY RD, MIDDLE RIVER, MD 21220-3882
(443) 681-6352
(443) 681-6352
Mailing address
9708 LANGLEY RD, MIDDLE RIVER, MD 21220-3882
(410) 499-3201

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PSC5373
TRANSPORTATION PROVIDER
MD
Enumeration date
09/16/2015
Last updated
09/16/2015
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