Individual provider · Type 1 NPI
Tae Seo Mardanov, CRNP
Neonatal Nurse Practitioner · Baltimore, MD
NPI number
1851066211
Active
Practice location
1800 Orleans St
Baltimore, MD 21287-0010
Mailing address
6201 Greenleigh Ave
Middle River, MD 21220-2004
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Neonatal Nurse Practitioner Primary | 363LN0000X | R251249 (MD) |
Neonatal Nurse Practitioner: Definition to come...
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About NPI 1851066211
Tae Seo Mardanov, CRNP's National Provider Identifier is 1851066211, issued on Aug 9, 2021. The primary taxonomy on file is Neonatal Nurse Practitioner (363LN0000X), and the practice location is in Baltimore, MD. The record was last updated on Sep 26, 2023.