Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | D66562 | MD |
Y | 208600000X | Surgeon | D66562 | MD |
NPI | 1013997964 |
---|---|
Provider Name | Dr. Ronald Brian Tesoriero |
First Address | Baltimore, MD 21264-4793 |
Second Address | Baltimore, MD 21201-1544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2006 |
Last Update Date | 12/09/2013 |