Individual provider · Type 1 NPI
Susan Demetrides, CPNP
Pediatric Nurse Practitioner · Baltimore, MD
NPI number
1356498786
Active
Practice location
707 N Broadway
Baltimore, MD 21205-1832
Fax (443) 923-9405
Mailing address
2931 E Biddle St
Baltimore, MD 21213-3939
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | R065937 (MD) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1356498786
Susan Demetrides, CPNP's National Provider Identifier is 1356498786, issued on Jan 5, 2007. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Baltimore, MD. The record was last updated on Jul 8, 2007.