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NPI Code Detail

MEDICARE: EMIL KWABLA FIASORGBOR

MEDICARE: EMIL KWABLA FIASORGBOR
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
12084P0800XPsychiatry PhysicianR208976MD

General Provider Information

NPI Number : 1659831808
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMIL KWABLA FIASORGBOR
Provider Business Mailing Address
First Line : 700 HENDERSON RD
Second Line :
City : BEL AIR
State : MD
Zip : 21014-2515
Country : US
Telephone Number : 443-655-9931
Fax Number :
Provider Business Practice Location Address
First Line : 7067 COLUMBIA GATEWAY DR STE 180
Second Line :
City : COLUMBIA
State : MD
Zip : 21046-3408
Country : US
Telephone Number : 410-929-7225
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2019
Last Update Date : 03/23/2019

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Directions to “ EMIL KWABLA FIASORGBOR ” Practice Location

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