Healthcare Provider Details

I. General information

NPI: 1457357931
Provider Name (Legal Business Name): EMILIE ANNE COLE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 08/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 ORLEANS ST
BALTIMORE MD
21224-1020
US

IV. Provider business mailing address

5450 KNOLL NORTH DR SUITE #180
COLUMBIA MD
21045-2373
US

V. Phone/Fax

Practice location:
  • Phone: 410-558-4747
  • Fax: 410-732-0185
Mailing address:
  • Phone: 410-964-6100
  • Fax: 410-964-5315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD39710
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: