Individual
MRS. LISA ANNE MARCINKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
9100 REXIS AVE, PERRY HALL, MD 21128-9604
(410) 256-1443
Mailing address
9100 REXIS AVE, PERRY HALL, MD 21128-9604
(410) 256-1443
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0002272
MD
Other
Enumeration date
06/18/2010
Last updated
06/18/2010
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