Healthcare Provider Details

I. General information

NPI: 1427582105
Provider Name (Legal Business Name): MARINA MOHEB-ANDRAWIS ESKANDAR M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 10/03/2023
Certification Date: 10/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S GREENE ST
BALTIMORE MD
21201-1544
US

IV. Provider business mailing address

8006 BRIGHTLIGHT PL
ELLICOTT CITY MD
21043-7961
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-6749
  • Fax:
Mailing address:
  • Phone: 703-231-0496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD89026
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: