Individual
TAE SEO MARDANOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1800 ORLEANS ST, BALTIMORE, MD 21287-0010
(410) 955-5000
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6423
(410) 500-4266
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
R251249
MD
Other
Enumeration date
08/09/2021
Last updated
09/26/2023
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