Healthcare Provider Details

I. General information

NPI: 1285893735
Provider Name (Legal Business Name): KRISTA MAREE MEHLHAFF DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2008
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 W REDWOOD ST STE 500
BALTIMORE MD
21201-7001
US

IV. Provider business mailing address

250 W PRATT ST STE 880
BALTIMORE MD
21201-6829
US

V. Phone/Fax

Practice location:
  • Phone: 667-214-1300
  • Fax: 410-328-2648
Mailing address:
  • Phone: 667-214-1302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number1.055227
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number34.010308
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberH96515
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: