Healthcare Provider Details

I. General information

NPI: 1114903531
Provider Name (Legal Business Name): NOREEN A HYNES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2005
Last Update Date: 08/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 E JEFFERSON ST JHU-SOM BOND STREET ANNEX SUITE 114
BALTIMORE MD
21287-0018
US

IV. Provider business mailing address

519 N THOMAS ST
ARLINGTON VA
22203-2405
US

V. Phone/Fax

Practice location:
  • Phone: 410-614-7196
  • Fax:
Mailing address:
  • Phone: 703-524-8413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberD0052112
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number60659
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0052112
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: