Individual
MR. TAVERSHIMA ASOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, RN, NP-C
Contact information
Practice address
1111 N CHARLES ST, BALTIMORE, MD 21201-5505
(410) 837-2050
Mailing address
3333 HOLLOW CT, ELLICOTT CITY, MD 21043-3485
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R216748
MD
363LF0000X
Family Nurse Practitioner
SP010531
PA
Other
Enumeration date
12/23/2009
Last updated
11/17/2016
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