Healthcare Provider Details

I. General information

NPI: 1558458513
Provider Name (Legal Business Name): HENRY S YORK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2006
Last Update Date: 12/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 KERNAN DR KERNAN HOSPITAL SPINAL CORD INJURY UNIT
BALTIMORE MD
21207-6665
US

IV. Provider business mailing address

2200 KERNAN DR KERNAN HOSPITAL SPINAL CORD INJURY UNIT
BALTIMORE MD
21207-6665
US

V. Phone/Fax

Practice location:
  • Phone: 410-448-6261
  • Fax: 410-448-6617
Mailing address:
  • Phone: 410-448-6261
  • Fax: 410-448-6617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License NumberD66057
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License NumberD66057
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: