Healthcare Provider Details

I. General information

NPI: 1598974701
Provider Name (Legal Business Name): KARINA M YELIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 09/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 GREENSPRING AVE
BALTIMORE MD
21211-1353
US

IV. Provider business mailing address

3901 GREENSPRING AVENUE CENTER FOR AUTISM AND RELATED DISORDERS
BALTIMORE MD
21211
US

V. Phone/Fax

Practice location:
  • Phone: 443-923-7646
  • Fax: 443-923-7638
Mailing address:
  • Phone: 443-923-7646
  • Fax: 443-923-7638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0068155
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: