Healthcare Provider Details

I. General information

NPI: 1104315290
Provider Name (Legal Business Name): THOMAS PATRICK FITZGERALD DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2018
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S GREENE ST
BALTIMORE MD
21201-1544
US

IV. Provider business mailing address

22 S GREENE ST PEDIATRIC PULMONOLOGY DIVISION
BALTIMORE MD
21201-1544
US

V. Phone/Fax

Practice location:
  • Phone: 410-706-2443
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberDO210001296
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License NumberH0104570
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: