Healthcare Provider Details

I. General information

NPI: 1750791349
Provider Name (Legal Business Name): JOEL C SUNSHINE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2014
Last Update Date: 09/18/2020
Certification Date: 09/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N CAROLINE ST # 8065
BALTIMORE MD
21287-0006
US

IV. Provider business mailing address

9910 FRANKLIN SQUARE DR STE 2110
BALTIMORE MD
21236-4902
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-5933
  • Fax: 410-502-2309
Mailing address:
  • Phone: 410-933-6423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberD89342
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: