Healthcare Provider Details

I. General information

NPI: 1467894923
Provider Name (Legal Business Name): PATRICK HAMILTON FINAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2013
Last Update Date: 07/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5510 NATHAN SHOCK DR SUITE 100
BALTIMORE MD
21224-6823
US

IV. Provider business mailing address

5510 NATHAN SHOCK DR SUITE 100
BALTIMORE MD
21224-6823
US

V. Phone/Fax

Practice location:
  • Phone: 410-550-7901
  • Fax: 410-550-0117
Mailing address:
  • Phone: 410-550-7901
  • Fax: 410-550-0117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number05129
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License Number05129
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: