Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | D0076900 | MD |
N | 207T00000X | Neurosurgeon | MT190445 | PA |
NPI | 1053519256 |
---|---|
Provider Name | Omar Akram Zalatimo |
First Address | Baltimore, MD 21209-3742 |
Second Address | Baltimore, MD 21209-3742 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2007 |
Last Update Date | 12/02/2015 |