Individual
GIDEON TAH FON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6 ROCK STORY CT, NONE, RANDALLSTOWN, MD 21133-2844
(443) 676-6123
Mailing address
6 ROCK STORY CT, RANDALLSTOWN, MD 21133-2844
(443) 676-6123
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R134373
MD
Other
Enumeration date
07/27/2020
Last updated
07/27/2020
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