Healthcare Provider Details

I. General information

NPI: 1053678409
Provider Name (Legal Business Name): KATHRYN M LEMBERG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2012
Last Update Date: 02/03/2020
Certification Date: 02/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 ORLEANS ST BLOOMBERG 11N
BALTIMORE MD
21287-0010
US

IV. Provider business mailing address

1800 ORLEANS ST
BALTIMORE MD
21287-0010
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-8751
  • Fax: 410-614-0028
Mailing address:
  • Phone: 410-955-8751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberD79158
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: