Healthcare Provider Details

I. General information

NPI: 1245578426
Provider Name (Legal Business Name): MARY JOY DRASS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARY JOY MAXWELL M.D.

II. Dates (important events)

Enumeration Date: 01/23/2013
Last Update Date: 01/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5565 STERRETT PL FL 5
COLUMBIA MD
21044-2665
US

IV. Provider business mailing address

5565 STERRETT PL FL 5
COLUMBIA MD
21044-2665
US

V. Phone/Fax

Practice location:
  • Phone: 410-772-6707
  • Fax: 410-715-3905
Mailing address:
  • Phone: 410-772-6707
  • Fax: 410-715-3905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberD0025605
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: