Healthcare Provider Details

I. General information

NPI: 1427577105
Provider Name (Legal Business Name): MARK MAZER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2017
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 W PRATT ST FL 2
BALTIMORE MD
21201-1023
US

IV. Provider business mailing address

701 W PRATT ST FL 2
BALTIMORE MD
21201-1023
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-6018
  • Fax: 410-328-6391
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD0097631
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberD0097631
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: