Healthcare Provider Details

I. General information

NPI: 1558921353
Provider Name (Legal Business Name): UGUR DAMAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2019
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1741 ASHLAND AVE
BALTIMORE MD
21205-1531
US

IV. Provider business mailing address

1741 ASHLAND AVE
BALTIMORE MD
21205-1531
US

V. Phone/Fax

Practice location:
  • Phone: 443-923-9520
  • Fax: 443-923-9165
Mailing address:
  • Phone: 443-923-9520
  • Fax: 443-923-9165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMT218874
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: