Individual
DR. SAMUEL AARON TISHERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-6704
(410) 328-4124
Mailing address
PO BOX 64793, BALTIMORE, MD 21264-4793
(410) 328-6704
(410) 328-4124
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
D77517
MD
2086S0102X
Surgical Critical Care Physician
MD037034E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001465048
—
PA
Enumeration date
02/24/2006
Last updated
06/02/2014
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