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1164483335
ROGER L DESHONG
RANDALLSTOWN, MD
NPI
1164483335
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: MD C0002602)
Enumeration Date
2006-03-29
Last Update Date
2007-10-19
Business Address
Mr. ROGER L DESHONG PA
5401 OLD COURT RD
RANDALLSTOWN, MD 21133-5103
Phone number: 410-521-2200
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Mailing Address
Mr. ROGER L DESHONG PA
5401 OLD COURT RD ATTN: CREDENTIALING
RANDALLSTOWN, MD 21133-5103
Phone number: 410-601-5524
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