Healthcare Provider Details

I. General information

NPI: 1518076579
Provider Name (Legal Business Name): DAVID E EAKIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 01/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 AIRPAX RD BUILDING B, STE 700
CAMBRIDGE MD
21613-6401
US

IV. Provider business mailing address

828 AIRPAX RD BUILDING B, STE 700
CAMBRIDGE MD
21613-6401
US

V. Phone/Fax

Practice location:
  • Phone: 410-901-8370
  • Fax: 410-901-8373
Mailing address:
  • Phone: 410-901-8370
  • Fax: 410-901-8373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMB70153
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: