Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | D0046611 | MD |
NPI | 1194857797 |
---|---|
Provider Name | Dr. Robert Redwood Bass |
First Address | Baltimore, MD 21201-1536 |
Second Address | Baltimore, MD 21201-1536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2007 |
Last Update Date | 08/07/2007 |