Individual
TITUS KOIMUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
107 BIERSTADT CT, FREDERICK, MD 21702-6442
(240) 252-8917
Mailing address
107 BIERSTADT CT, FREDERICK, MD 21702-6442
(240) 252-8917
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R189596
MD
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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