Healthcare Provider Details

I. General information

NPI: 1669791497
Provider Name (Legal Business Name): YASMIN AKHTAR D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2010
Last Update Date: 12/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N WOLFE ST SUITE 3120
BALTIMORE MD
21287-0011
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 410-955-6463
  • Fax:
Mailing address:
  • Phone: 410-933-6421
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberH83969
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License NumberP30392
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: