Healthcare Provider Details

I. General information

NPI: 1457386484
Provider Name (Legal Business Name): ALDERMAN & LUMPKIN ET AL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 09/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 NORTH CHARLES STREET SUITE 601
BALTIMORE MD
21204
US

IV. Provider business mailing address

6565 NORTH CHARLES STREET SUITE 601
BALTIMORE MD
21204
US

V. Phone/Fax

Practice location:
  • Phone: 410-821-5151
  • Fax: 410-823-8309
Mailing address:
  • Phone: 410-821-5151
  • Fax: 410-823-7866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number00000
License Number StateMD

VIII. Authorized Official

Name: DENISE N WINGERD
Title or Position: OFFICE MANAGER
Credential:
Phone: 410-821-5151