Healthcare Provider Details

I. General information

NPI: 1659416576
Provider Name (Legal Business Name): ELLEN FRANCINE LEMKIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 10/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4940 EASTERN AVE
BALTIMORE MD
21224-2735
US

IV. Provider business mailing address

110 S PACA ST EMERGENCY MEDICINE, 6TH FLOOR
BALTIMORE MD
21201-1642
US

V. Phone/Fax

Practice location:
  • Phone: 410-550-7852
  • Fax: 410-550-0178
Mailing address:
  • Phone: 410-328-8025
  • Fax: 410-328-8028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD67207
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: