Provider First Line Business Practice Location Address:
1550 ORLEANS ST
Provider Second Line Business Practice Location Address:
JOHNS HOPKINS, DEPT OF DERMATOLOG CRBII-SUITES 209/210
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-955-8662
Provider Business Practice Location Address Fax Number:
410-955-8645
Provider Enumeration Date:
04/06/2009