Healthcare Provider Details

I. General information

NPI: 1407846769
Provider Name (Legal Business Name): RODNEY E. GROLMAN, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3421 BENSON AVE STE 210
BALTIMORE MD
21227-1056
US

IV. Provider business mailing address

8 CHARLES PLZ APT 2704
BALTIMORE MD
21201-4238
US

V. Phone/Fax

Practice location:
  • Phone: 410-368-2700
  • Fax: 410-368-3569
Mailing address:
  • Phone: 410-368-2700
  • Fax: 410-368-3569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberD0060134
License Number StateMD

VIII. Authorized Official

Name: DR. RODNEY EDMIN GROLMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 410-368-2700