Healthcare Provider Details

I. General information

NPI: 1437108073
Provider Name (Legal Business Name): NATALIE MCCALL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4940 EASTERN AVE
BALTIMORE MD
21224-2735
US

IV. Provider business mailing address

PO BOX 64316
BALTIMORE MD
21264-4316
US

V. Phone/Fax

Practice location:
  • Phone: 410-550-0967
  • Fax:
Mailing address:
  • Phone: 410-933-1241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License NumberD60746
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: