Provider Demographics
NPI:1376170985
Name:MAO, SERENA (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:SERENA
Middle Name:
Last Name:MAO
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N BROADWAY ST STE 1440
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21287-0019
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 NORTH BROADWAY
Practice Address - Street 2:SUITE 1440
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231
Practice Address - Country:US
Practice Address - Phone:410-955-7390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-24
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program