Healthcare Provider Details

I. General information

NPI: 1912477944
Provider Name (Legal Business Name): JEFFREY AUSTIN ELSNER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2018
Last Update Date: 02/17/2026
Certification Date: 02/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 ST. PAUL PLACE BUNTING BLDG 7TH FLOOR
BALTIMORE MD
21202
US

IV. Provider business mailing address

345 ST. PAUL PLACE BUNTING BLDG 7TH FLOOR
BALTIMORE MD
21202
US

V. Phone/Fax

Practice location:
  • Phone: 410-332-9694
  • Fax:
Mailing address:
  • Phone: 410-332-9694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberD0097249
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: