Healthcare Provider Details
I. General information
NPI: 1780727420
Provider Name (Legal Business Name): CHRISTINA C ENZMANN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/14/2007
Last Update Date: 05/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
419 W REDWOOD ST SUITE 500
BALTIMORE MD
21201-1734
US
IV. Provider business mailing address
250 W PRATT ST SUITE 880
BALTIMORE MD
21201-2423
US
V. Phone/Fax
- Phone: 667-214-1300
- Fax: 410-328-2648
- Phone: 667-214-1302
- Fax: 410-328-3379
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | P20623 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | D0070444 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: