Johann Marcelino Peniche

NPI #1164254868 in Bel Air, Maryland

Provider Information

NPI Number: 1164254868
Entity Type: Individual
Name: Johann Marcelino Peniche
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Aug 20, 2024
Last Updated: Aug 20, 2024

Practice Location

Address: 12 MEDSTAR BLVD STE 255
City: Bel Air
State: Maryland
ZIP Code: 21015-1798
Phone: (580) 583-3907

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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