Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 255431 | MA |
N | 111NI0900X | Internist | 255431 | MA |
Y | 207RA0401X | Internist - Addiction Medicine | D81554 | MD |
NPI | 1710257290 |
---|---|
Provider Name | Megan Buresh |
First Address | Baltimore, MD 21224-2734 |
Second Address | Baltimore, MD 21224-2734 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/12/2011 |
Last Update Date | 29/10/2019 |