Healthcare Provider Details

I. General information

NPI: 1962829184
Provider Name (Legal Business Name): JULIE HURVITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2014
Last Update Date: 07/01/2021
Certification Date: 07/01/2021
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:
Mailing address:
  • Phone: 667-214-1302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD0085475
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: