Doctor Name: | RONALD SASSON MUKAMAL |
NPI Number: | 1275683443 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | D0044899 |
Business Practice Address: | 304 Reisterstown Road Baltimore, MD - 21208 |
Business Phone Number: | 4106020407 |
Business Fax Number: | 4106020409 |
Mailing Address: | 7216 Denberg Road, BALTIMORE |
State: | MD |
Postal Code: | 212091006 |
Phone Number: | 4103028848 |
Fax Number: | 4106020409 |
NPI Enumeration Date: | 01/11/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | D0044899 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |