Healthcare Provider Details

I. General information

NPI: 1184636680
Provider Name (Legal Business Name): DAWN KOBRIN-MERRITTS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9649 BELAIR RD SECOND FLOOR
BALTIMORE MD
21236-1100
US

IV. Provider business mailing address

303 AIKEN TER
ABINGDON MD
21009-2003
US

V. Phone/Fax

Practice location:
  • Phone: 410-256-9340
  • Fax:
Mailing address:
  • Phone: 410-515-1628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0035365
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: