Healthcare Provider Details

I. General information

NPI: 1225177157
Provider Name (Legal Business Name): MICHAEL JOSEPH JAMES D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 01/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N WOLFE ST DEPARTMENT OF ANESTHESIA AND CRITICAL CARE MEDICINE
BALTIMORE MD
21287-4904
US

IV. Provider business mailing address

1 THREE SISTERS WAY
BALDWIN MD
21013-9792
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-7609
  • Fax: 410-955-5607
Mailing address:
  • Phone: 330-719-2674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberH65821
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: