Healthcare Provider Details

I. General information

NPI: 1871884916
Provider Name (Legal Business Name): AMOL NARANG
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2011
Last Update Date: 08/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N BROADWAY SUITE 1440
BALTIMORE MD
21231-1104
US

IV. Provider business mailing address

400 N BROADWAY SUITE 1440
BALTIMORE MD
21231-1104
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-6980
  • Fax: 410-502-1419
Mailing address:
  • Phone: 410-955-6980
  • Fax: 410-502-1419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberD81822
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: