Healthcare Provider Details

I. General information

NPI: 1477085496
Provider Name (Legal Business Name): SARAH BRONWYN LOWRY ADAMITIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 06/02/2024
Certification Date: 06/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 NORTH BROADWAY RM 1003
BALTIMORE MD
21264-1011
US

IV. Provider business mailing address

550 N BROADWAY
BALTIMORE MD
21205-2020
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-8769
  • Fax:
Mailing address:
  • Phone: 410-955-8769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberD89011
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMT214069
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD89011
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: