Healthcare Provider Details

I. General information

NPI: 1720585086
Provider Name (Legal Business Name): ERIN POWERS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2018
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2024 WEST ST STE 400
ANNAPOLIS MD
21401-3552
US

IV. Provider business mailing address

2024 WEST ST STE 400
ANNAPOLIS MD
21401-3552
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0091907
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: