SHAVONTAY TATE

BALTIMORE, MD
NPI1922766138
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
Enumeration Date2021-12-05
Last Update Date2022-03-16
Business Address
SHAVONTAY TATE PA-C
5601 LOCH RAVEN BLVD
BALTIMORE, MD 21239-2945
Phone number: 443-469-8227
Mailing Address
SHAVONTAY TATE PA-C
201 E UNIVERSITY PKWY
BALTIMORE, MD 21218-2829
Phone number: 410-554-2000