Healthcare Provider Details

I. General information

NPI: 1174591713
Provider Name (Legal Business Name): BARUCH FRIEDMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 LOCH RAVEN BLVD RUSSELL MORGAN BLDG., 3RD FLOOR
BALTIMORE MD
21239-2905
US

IV. Provider business mailing address

5601 LOCH RAVEN BLVD RUSSELL MORGAN BLDG., 3RD FLOOR
BALTIMORE MD
21239-2905
US

V. Phone/Fax

Practice location:
  • Phone: 410-464-5600
  • Fax: 410-532-5630
Mailing address:
  • Phone: 410-464-5600
  • Fax: 410-532-5630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberD37565
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: