Healthcare Provider Details

I. General information

NPI: 1467622001
Provider Name (Legal Business Name): JOSEPH B GIRLANDO DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2008
Last Update Date: 03/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7131 LIBERTY RD SUITE 104
BALTIMORE MD
21207-4580
US

IV. Provider business mailing address

7131 LIBERTY RD SUITE 104
BALTIMORE MD
21207-4580
US

V. Phone/Fax

Practice location:
  • Phone: 410-944-8805
  • Fax: 410-944-2370
Mailing address:
  • Phone: 410-944-8805
  • Fax: 410-944-2370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number00528
License Number StateMD

VIII. Authorized Official

Name: JOSEPH BLAISK GIRLAND
Title or Position: PODIATRIST OWNER
Credential: DPM
Phone: 410-944-8805