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General NPI Number Information
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NPI Number | 1558436436
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Entity Type | Individual
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Provider Name | NADINE KFOURY OSWALD PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/23/2006
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Last Update Date | 12/30/2012
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Provider Practice Location Address
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Address Line | 617 STEMMERS RUN RD STE F
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City | BALTIMORE
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State | MD
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Zip | 21221-3361
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Country | US
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Telephone | 410-780-3640
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Fax |
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Provider Business Mailing Address
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Address Line | 2104 WOODFORK RD
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City | TIMONIUM
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State | MD
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Zip | 21093-3033
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Country | US
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Telephone | 410-252-8962
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | C0000614
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License Number State | MD
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