Provider Demographics
NPI:1114086972
Name:ASSAN, PATRICIA AGNES (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:AGNES
Last Name:ASSAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6501 N CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21204-6819
Mailing Address - Country:US
Mailing Address - Phone:410-938-3464
Mailing Address - Fax:410-938-3410
Practice Address - Street 1:9030 STATE ROUTE 108
Practice Address - Street 2:OAKLAND CENTER
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1951
Practice Address - Country:US
Practice Address - Phone:410-938-3464
Practice Address - Fax:410-938-3410
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD00532282084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry