Healthcare Provider Details

I. General information

NPI: 1255868352
Provider Name (Legal Business Name): BRYNN DONNELLY O'LAUGHLIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2017
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2411 W BELVEDERE AVE STE 407
BALTIMORE MD
21215-5231
US

IV. Provider business mailing address

111 MICHIGAN AVE NW 3.5 WEST WING, ROOM 700
WASHINGTON DC
20010-2916
US

V. Phone/Fax

Practice location:
  • Phone: 410-601-8663
  • Fax: 410-601-5389
Mailing address:
  • Phone: 202-476-5694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number40929
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberD0099956
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: