Healthcare Provider Details

I. General information

NPI: 1245348523
Provider Name (Legal Business Name): MARIETA SANCHEZ CARAGAY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 07/19/2021
Certification Date: 07/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3455 WILKENS AVE STE 102
BALTIMORE MD
21229-5204
US

IV. Provider business mailing address

706 IVY HILL RD
HUNT VALLEY MD
21030
US

V. Phone/Fax

Practice location:
  • Phone: 410-355-2822
  • Fax: 410-355-2823
Mailing address:
  • Phone: 410-355-2822
  • Fax: 410-771-1754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0028166
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: