Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | D48386 | MD |
NPI | 1003909698 |
---|---|
Provider Name | Ashley Behrens |
First Address | Baltimore, MD 21264-4481 |
Second Address | Baltimore, MD 21287 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 08/07/2007 |