Healthcare Provider Details

I. General information

NPI: 1548420433
Provider Name (Legal Business Name): ALBERT DONNAY MHS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2008
Last Update Date: 06/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6101 GENTRY LN
BALTIMORE MD
21210-1035
US

IV. Provider business mailing address

6101 GENTRY LN
BALTIMORE MD
21210-1035
US

V. Phone/Fax

Practice location:
  • Phone: 443-465-7894
  • Fax:
Mailing address:
  • Phone: 443-465-7894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: