Healthcare Provider Details

I. General information

NPI: 1619098696
Provider Name (Legal Business Name): WILLIAM J POGODA MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 SCHILLING ROAD #LL3
HUNT VALLEY MD
21031-8644
US

IV. Provider business mailing address

9 SCHILLING ROAD #LL3
HUNT VALLEY MD
21031-8644
US

V. Phone/Fax

Practice location:
  • Phone: 410-771-8080
  • Fax: 410-771-8088
Mailing address:
  • Phone: 410-771-8080
  • Fax: 410-771-8088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD23700
License Number StateMD

VIII. Authorized Official

Name: WILLIAM J POGODA
Title or Position: OPHTHALMOLOGIST
Credential: MD
Phone: 410-771-8080