Healthcare Provider Details

I. General information

NPI: 1174055412
Provider Name (Legal Business Name): JAMES ANDREW AIROLDI JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 07/24/2020
Certification Date: 07/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 FRANKLIN SQUARE DR
BALTIMORE MD
21237-3901
US

IV. Provider business mailing address

263 FARMINGTON AVE
FARMINGTON CT
06030-1921
US

V. Phone/Fax

Practice location:
  • Phone: 443-777-7000
  • Fax:
Mailing address:
  • Phone: 860-679-4763
  • Fax: 860-679-4624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD89676
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: