Healthcare Provider Details

I. General information

NPI: 1548438211
Provider Name (Legal Business Name): RICHARD J NOBLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 09/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8109 HARFORD RD STE B
BALTIMORE MD
21234-9205
US

IV. Provider business mailing address

8109 HARFORD RD STE B
BALTIMORE MD
21234-9205
US

V. Phone/Fax

Practice location:
  • Phone: 410-661-2132
  • Fax: 410-882-9222
Mailing address:
  • Phone: 410-661-2132
  • Fax: 410-882-9222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number981
License Number StateMD

VIII. Authorized Official

Name: PAUL ROTHWELL
Title or Position: BILLING MANAGER
Credential:
Phone: 604-599-1895