Healthcare Provider Details

I. General information

NPI: 1033177266
Provider Name (Legal Business Name): EDITH D GUREWITSCH ALLEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EDITH D GUREWITSCH M.D.

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N WOLFE ST NELSON 2 OBSTETRICS PRACTICE
BALTIMORE MD
21287-0005
US

IV. Provider business mailing address

PO BOX 64313
BALTIMORE MD
21264-4313
US

V. Phone/Fax

Practice location:
  • Phone: 410-502-3148
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD52071
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number190280
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: