Healthcare Provider Details

I. General information

NPI: 1265889349
Provider Name (Legal Business Name): BRIANNA AOYAMA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2016
Last Update Date: 07/22/2022
Certification Date: 07/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N WOLFE ST STE 3075
BALTIMORE MD
21287
US

IV. Provider business mailing address

200 N WOLFE ST STE 3075
BALTIMORE MD
21287-0011
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-2035
  • Fax: 410-955-1030
Mailing address:
  • Phone: 410-955-2035
  • Fax: 410-955-1030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberD0087423
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: