Healthcare Provider Details

I. General information

NPI: 1295848307
Provider Name (Legal Business Name): INFECTIOUS DISEASES CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E 33RD ST SUITE 640
BALTIMORE MD
21218-3322
US

IV. Provider business mailing address

200 E 33RD ST SUITE 640
BALTIMORE MD
21218-3322
US

V. Phone/Fax

Practice location:
  • Phone: 410-366-4441
  • Fax:
Mailing address:
  • Phone: 410-366-4441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberD38282
License Number StateMD

VIII. Authorized Official

Name: DR. PAUL A EDER
Title or Position: PRESIDENT
Credential: MD
Phone: 410-366-4441