Healthcare Provider Details

I. General information

NPI: 1316155377
Provider Name (Legal Business Name): MARCELINO D. ALBUERNE, M.D. P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 08/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 N ROLLING RD SUITE 106
CATONSVILLE MD
21228-4140
US

IV. Provider business mailing address

516 N ROLLING RD SUITE 106
CATONSVILLE MD
21228-4140
US

V. Phone/Fax

Practice location:
  • Phone: 410-744-4044
  • Fax: 410-744-7923
Mailing address:
  • Phone: 410-744-4044
  • Fax: 410-744-7923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberD29769
License Number StateMD

VIII. Authorized Official

Name: MRS. LESA MARIE BEREZNAY
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 410-744-4044