Individual
REBECCA BAUSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
419 W REDWOOD ST STE 470, BALTIMORE, MD 21201
(667) 214-1197
Mailing address
419 W REDWOOD ST STE 470, BALTIMORE, MD 21201-7009
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
D0086904
MD
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/13/2015
Last updated
06/04/2019
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