Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife | DEM00029 | MD |
NPI | 1104416858 |
---|---|
Provider Name | Tess Sarah Brody |
First Address | Baltimore, MD 21215-3751 |
Second Address | Baltimore, MD 21215-3751 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2021 |
Last Update Date | 26/01/2021 |