Healthcare Provider Details

I. General information

NPI: 1801959507
Provider Name (Legal Business Name): STEVEN ANDRE SOLOMON L. AC., DIPL. AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 WYNDHURST AVE. SUITE 305
BALTIMORE MD
21210
US

IV. Provider business mailing address

600 WYNDHURST AVE. SUITE 305
BALTIMORE MD
21210
US

V. Phone/Fax

Practice location:
  • Phone: 410-404-5282
  • Fax: 410-435-8010
Mailing address:
  • Phone: 410-404-5282
  • Fax: 410-435-8010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU00910
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: