Healthcare Provider Details

I. General information

NPI: 1497750624
Provider Name (Legal Business Name): JOSEPH J CIOTOLA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 10/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 ST. PAUL PLACE, LOBBY LEVEL ORTHOPEDIC AND JOINT REPLACEMENT
BALTIMORE MD
21202
US

IV. Provider business mailing address

301 ST. PAUL PLACE, LOBBY LEVEL ORTHOPEDIC AND JOINT REPLACEMENT
BALTIMORE MD
21202
US

V. Phone/Fax

Practice location:
  • Phone: 410-539-2227
  • Fax:
Mailing address:
  • Phone: 410-539-2227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberD0060007
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberD0060007
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD0060000007
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: