Healthcare Provider Details

I. General information

NPI: 1497961643
Provider Name (Legal Business Name): ANNE BAILOWITZ MD, MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 S FREDERICK ST FL 3
BALTIMORE MD
21202-4028
US

IV. Provider business mailing address

3512 NEWLAND RD
BALTIMORE MD
21218-2512
US

V. Phone/Fax

Practice location:
  • Phone: 410-236-9285
  • Fax: 410-889-2941
Mailing address:
  • Phone: 410-236-9285
  • Fax: 410-889-2941

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD26524
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: