Healthcare Provider Details

I. General information

NPI: 1518003912
Provider Name (Legal Business Name): ANTHONY GEORGE DURMOWICZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N WOLFE ST SUITE 3022
BALTIMORE MD
21287-0001
US

IV. Provider business mailing address

865 STILL CREEK LN
GAITHERSBURG MD
20878-3218
US

V. Phone/Fax

Practice location:
  • Phone: 443-287-8977
  • Fax:
Mailing address:
  • Phone: 301-963-8466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberD0033853
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: