Individual
SHEKU RICHARD THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
3500 BOSTON ST, BALTIMORE, MD 21224-5251
(443) 266-3943
Mailing address
3500 BOSTON ST, BALTIMORE, MD 21224-5251
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
R180781
MD
363LA2100X
Acute Care Nurse Practitioner
RN1024901
DC
363LG0600X
Gerontology Nurse Practitioner
R180781
MD
363LG0600X
Gerontology Nurse Practitioner
RN1024901
DC
Other
Enumeration date
09/07/2019
Last updated
09/07/2019
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