Healthcare Provider Details

I. General information

NPI: 1497793673
Provider Name (Legal Business Name): DANIEL RAY HOWARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 11/10/2022
Certification Date: 11/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 N PACA ST FIRST FLOOR
BALTIMORE MD
21201-1815
US

IV. Provider business mailing address

1714 EUTAW PL SUITE 2A
BALTIMORE MD
21217-3730
US

V. Phone/Fax

Practice location:
  • Phone: 410-779-9609
  • Fax: 443-552-4758
Mailing address:
  • Phone: 410-779-9609
  • Fax: 443-552-4758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberD43386
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: