Healthcare Provider Details

I. General information

NPI: 1366653560
Provider Name (Legal Business Name): MARY L CUTLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2007
Last Update Date: 03/29/2024
Certification Date: 03/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6802 MCCLEAN BLVD
BALTIMORE MD
21234-7200
US

IV. Provider business mailing address

6802 MCCLEAN BLVD
BALTIMORE MD
21234-7200
US

V. Phone/Fax

Practice location:
  • Phone: 443-725-6286
  • Fax: 410-870-4998
Mailing address:
  • Phone: 443-725-6286
  • Fax: 410-870-4998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberD69313
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberD69313
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: