Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | DOOO4251 | MD |
NPI | 1245474063 |
---|---|
Provider Name | Dr. Fidelis Caroline Define |
First Address | Towson, MD 21204-6808 |
Second Address | Towson, MD 21204-6808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2009 |
Last Update Date | 28/05/2009 |