Healthcare Provider Details

I. General information

NPI: 1083108864
Provider Name (Legal Business Name): MEREDITH REGINA KRUZITS AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MEREDITH FRANK AU. D.

II. Dates (important events)

Enumeration Date: 06/15/2018
Last Update Date: 08/23/2021
Certification Date: 08/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6565 N CHARLES ST STE 601
BALTIMORE MD
21204
US

IV. Provider business mailing address

6565 N CHARLES ST STE 601
BALTIMORE MD
21204-5801
US

V. Phone/Fax

Practice location:
  • Phone: 410-821-5151
  • Fax: 410-823-8309
Mailing address:
  • Phone: 410-821-5152
  • Fax: 410-823-7866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number01473
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: