Healthcare Provider Details

I. General information

NPI: 1174501381
Provider Name (Legal Business Name): JOHN BRUCE NAIMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 12/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7850 EASTERN AVE
BALTIMORE MD
21224
US

IV. Provider business mailing address

7850 EASTERN AVE
BALTIMORE MD
21224
US

V. Phone/Fax

Practice location:
  • Phone: 410-282-4848
  • Fax: 410-282-4849
Mailing address:
  • Phone: 410-282-4848
  • Fax: 410-282-4849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD0036470
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: