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1881152783
MARK ANTHONY BERGONIA ISON
BALTIMORE, MD
NPI
1881152783
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: MD R181848)
Enumeration Date
2019-03-09
Last Update Date
2019-03-09
Business Address
Mr. MARK ANTHONY BERGONIA ISON CRNP- PMH
1501 SULGRAVE AVE STE 200
BALTIMORE, MD 21209-3650
Phone number: 443-708-5856
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Mailing Address
Mr. MARK ANTHONY BERGONIA ISON CRNP- PMH
1501 SULGRAVE AVE STE 200
BALTIMORE, MD 21209-3650
Phone number:
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