Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | D92008 | MD |
NPI | 1740676568 |
---|---|
Provider Name | Mrs. Julia Foster Shalen |
First Address | Middle River, MD 21220-2004 |
Second Address | Baltimore, MD 21287-0005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2015 |
Last Update Date | 07/09/2021 |