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Individual

DEIRDRE A. HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
7253 AMBASSADOR RD, BALTIMORE, MD 21244-2710
(443) 436-1114
Mailing address
7253 AMBASSADOR RD, BALTIMORE, MD 21244-2710
(443) 436-1114

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D0075768
MD
2085R0202X
Diagnostic Radiology Physician
MD445246
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
330340300
MD
01
P01212073
RR MEDICARE
MD
Enumeration date
06/24/2009
Last updated
02/18/2014
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