Healthcare Provider Details

I. General information

NPI: 1528324431
Provider Name (Legal Business Name): IRINI DIMITRIOS BATSIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 05/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N WOLFE ST STE CMSC2116
BALTIMORE MD
21287
US

IV. Provider business mailing address

9910 FRANKLIN SQUARE DR STE 2110
BALTIMORE MD
21236-4902
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-8769
  • Fax: 410-955-1464
Mailing address:
  • Phone: 410-933-2704
  • Fax: 410-933-1390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD83468
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: