Healthcare Provider Details

I. General information

NPI: 1508284092
Provider Name (Legal Business Name): DIANA LADKANY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2014
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 S HANOVER ST. DEPARTMENT OF EMERGENCY MEDICINE
BALTIMORE MD
21225
US

IV. Provider business mailing address

WHC PHYSICIAN GROUP LLC PO BOX 418283
BOSTON MA
02241-8283
US

V. Phone/Fax

Practice location:
  • Phone: 410-350-3477
  • Fax:
Mailing address:
  • Phone: 703-558-1544
  • 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 Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD045166
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0082886
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: