Healthcare Provider Details

I. General information

NPI: 1851300834
Provider Name (Legal Business Name): MICHELLE GELKIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2835 SMITH AVE STE 201
BALTIMORE MD
21209-1462
US

IV. Provider business mailing address

2835 SMITH AVE STE 201
BALTIMORE MD
21209-1462
US

V. Phone/Fax

Practice location:
  • Phone: 410-486-7747
  • Fax: 410-486-7764
Mailing address:
  • Phone: 410-486-7747
  • Fax: 410-486-7764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberD28187
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: