Healthcare Provider Details

I. General information

NPI: 1750164208
Provider Name (Legal Business Name): ORIANA KELEMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2023
Last Update Date: 09/05/2023
Certification Date: 09/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N. WOLFE STREET HALSTED 600
BALTIMORE MD
21287
US

IV. Provider business mailing address

600 N. WOLFE STREET HALSTED 600
BALTIMORE MD
21287
US

V. Phone/Fax

Practice location:
  • Phone: 410-502-2651
  • Fax:
Mailing address:
  • Phone: 410-502-2651
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC0009022
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: