MEDICARE: MARIAMA JALLOW MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	D0107193	MD

General Provider Information

NPI Number	:	1285363200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIAMA JALLOW MD

Provider Business Mailing Address
First Line	:	2661 RIVA RD STE 1030
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-7131
Country	:	US
Telephone Number	:	410-571-8733
Fax Number	:	410-571-6309

Provider Business Practice Location Address
First Line	:	3110 LORD BALTIMORE DR STE 103
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21244-2644
Country	:	US
Telephone Number	:	410-277-3937
Fax Number	:	410-281-9388

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2022
Last Update Date	:	06/12/2026

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Directions to “ MARIAMA JALLOW MD” Practice Location

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