Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | D67411 | MD |
NPI | 1124148341 |
---|---|
Provider Name | Dr. Seyed Ali Fatemi |
First Address | Baltimore, MD 21264-4227 |
Second Address | Baltimore, MD 21205-1832 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2007 |
Last Update Date | 28/04/2012 |