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1548203482
PRUDENCE JACKSON
BALTIMORE, MD
NPI
1548203482
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: MD D37659)
Enumeration Date
2006-06-14
Last Update Date
2007-07-08
Business Address
-- PRUDENCE JACKSON MD
900 CATON AVE
BALTIMORE, MD 21229-5201
Phone number: 410-368-2014
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Mailing Address
-- PRUDENCE JACKSON MD
10515 BILL LILLY CT
LAUREL, MD 20723-1291
Phone number: 301-953-2747
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