Provider Demographics
NPI:1225359375
Name:FOLLMER, GRACE RABAMUT-ALI (GRACE FOLLMER, OD)
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:RABAMUT-ALI
Last Name:FOLLMER
Suffix:
Gender:F
Credentials:GRACE FOLLMER, OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 FELL ST.
Mailing Address - Street 2:#618
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231
Mailing Address - Country:US
Mailing Address - Phone:443-279-8979
Mailing Address - Fax:
Practice Address - Street 1:960 FELL ST.
Practice Address - Street 2:#618
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231
Practice Address - Country:US
Practice Address - Phone:443-279-8979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD#675152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist