Healthcare Provider Details

I. General information

NPI: 1629378633
Provider Name (Legal Business Name): DANIELLE NAJOUM YOUNG PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2010
Last Update Date: 12/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S CATON AVE
BALTIMORE MD
21229-5201
US

IV. Provider business mailing address

PO BOX 631568
BALTIMORE MD
21263-1568
US

V. Phone/Fax

Practice location:
  • Phone: 667-234-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC004314
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: