Healthcare Provider Details

I. General information

NPI: 1346272655
Provider Name (Legal Business Name): NATHAN SKLAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 HOPKINS BAYVIEW CIR
BALTIMORE MD
21224-6821
US

IV. Provider business mailing address

PO BOX 64358
BALTIMORE MD
21264-4358
US

V. Phone/Fax

Practice location:
  • Phone: 410-550-2948
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberD22127
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: