Healthcare Provider Details

I. General information

NPI: 1487139424
Provider Name (Legal Business Name): PABLO F. RESTREPO PA-C/MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2018
Last Update Date: 08/23/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

JOHNS HOPKINS BAYVIEW MEDICAL CENTER 4950 EASTERN AVE / BLDG A - 6TH FLOOR
BALTIMORE MD
21224
US

IV. Provider business mailing address

JOHNS HOPKINS BAYVIEW MEDICAL CENTER 4950 EASTERN AVE / BLDG A - 6TH FLOOR
BALTIMORE MD
21224
US

V. Phone/Fax

Practice location:
  • Phone: 410-550-0101
  • Fax: 410-367-3278
Mailing address:
  • Phone: 410-550-0101
  • Fax: 410-367-3278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberC0008490
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: