Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 25084 | NE |
Y | 207L00000X | Anesthesiologist | D0071908 | MD |
NPI | 1013114669 |
---|---|
Provider Name | Deondra Patrice-Simmons Asike |
First Address | Towson, MD 21204 |
Second Address | Towson, MD 21204-6808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2007 |
Last Update Date | 08/03/2019 |