Healthcare Provider Details

I. General information

NPI: 1518130970
Provider Name (Legal Business Name): ELAINE GIANNAKOS LENNOX M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2008
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W BELVEDERE AVE
BALTIMORE MD
21215-5216
US

IV. Provider business mailing address

3706A MEADOWHILL CT
PHOENIX MD
21131-1700
US

V. Phone/Fax

Practice location:
  • Phone: 410-601-6162
  • Fax:
Mailing address:
  • Phone: 410-627-7286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD72078
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0072078
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD0072078
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: