Healthcare Provider Details

I. General information

NPI: 1386760254
Provider Name (Legal Business Name): NOLD AND ESCOBOSA P A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 02/28/2023
Certification Date: 02/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 WEST ST STE 400
ANNAPOLIS MD
21401-3552
US

IV. Provider business mailing address

2568A RIVA RD STE 103
ANNAPOLIS MD
21401-7457
US

V. Phone/Fax

Practice location:
  • Phone: 410-224-7667
  • Fax: 410-573-4926
Mailing address:
  • Phone: 410-224-7667
  • Fax: 410-573-4926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY NOLD
Title or Position: OWNER
Credential: DO
Phone: 410-224-3848