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NPI Code Detail

MEDICARE: NAM IN

MEDICARE:   NAM  IN
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
11223G0001XGeneral Practice Dentistry13661MD

General Provider Information

NPI Number : 1598818056
Entity Type Code : Individual
Provider Name (Legal Business Name) : NAM IN
Provider Business Mailing Address
First Line : 1496 REISTERSTOWN RD
Second Line :
City : PIKESVILLE
State : MD
Zip : 21208-3817
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1496 REISTERSTOWN RD
Second Line :
City : PIKESVILLE
State : MD
Zip : 21208-3817
Country : US
Telephone Number : 410-653-2622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2007
Last Update Date : 07/08/2007

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Directions to “ NAM IN ” Practice Location

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