Most Relevant Information
Provider Data
| NPI Number: | 1003679572 |
| Provider Name: | TARA SRINIVAS |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/06/2024 |
| Last Updated: | 02/06/2024 |
Provider Practice Location
733 N BROADWAY STE 147
BALTIMORE
MD
212051832
Practice Location Phone/Fax
| Phone: | 4109553080 |
| Fax: |
Provider Mailing Location
733 N BROADWAY STE 147
BALTIMORE
MD
212051832
Provider Mailing Phone/Fax
| Phone: | 4109553080 |
| Fax: |