Healthcare Provider Details

I. General information

NPI: 1053739748
Provider Name (Legal Business Name): MARYANN GARCIA-PHILLIP MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2014
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E EAGER ST
BALTIMORE MD
21202-5533
US

IV. Provider business mailing address

1000 E EAGER ST
BALTIMORE MD
21202-5533
US

V. Phone/Fax

Practice location:
  • Phone: 410-522-9800
  • Fax:
Mailing address:
  • Phone: 410-522-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD-0090099
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number288786
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: