Healthcare Provider Details

I. General information

NPI: 1649219155
Provider Name (Legal Business Name): CAROL K TWEED MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 12/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 MEDICAL PKWY SUITE 210
ANNAPOLIS MD
21401-7992
US

IV. Provider business mailing address

PO BOX 12622
BELFAST ME
04915-4017
US

V. Phone/Fax

Practice location:
  • Phone: 410-573-5300
  • Fax: 410-573-5305
Mailing address:
  • Phone: 443-481-6571
  • Fax: 443-481-6515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD422644
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberD74092
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: