Healthcare Provider Details

I. General information

NPI: 1629411558
Provider Name (Legal Business Name): ALEXANDER JOSEPH AMBINDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2013
Last Update Date: 09/14/2021
Certification Date: 09/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 ORLEANS ST # 1186
BALTIMORE MD
21287-0013
US

IV. Provider business mailing address

6201 GREENLEIGH AVE
MIDDLE RIVER MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 410-614-4459
  • Fax: 410-955-0125
Mailing address:
  • Phone: 410-933-1340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberD81117
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: