Healthcare Provider Details

I. General information

NPI: 1356507552
Provider Name (Legal Business Name): ERIC DOBSON MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2008
Last Update Date: 08/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 GARRISON BLVD #202
BALTIMORE MD
21216-2335
US

IV. Provider business mailing address

2300 GARRISON BLVD #202
BALTIMORE MD
21216-2335
US

V. Phone/Fax

Practice location:
  • Phone: 410-947-2460
  • Fax:
Mailing address:
  • Phone: 410-947-2460
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD39108
License Number StateMD

VIII. Authorized Official

Name: DR. ERIC DOBSON
Title or Position: OWNER
Credential: M.D.
Phone: 410-947-2460