Healthcare Provider Details

I. General information

NPI: 1083865018
Provider Name (Legal Business Name): RICHARD E LAYTON MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2008
Last Update Date: 10/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 DULANEY VALLEY RD DULANEY CENTER 2 SUITE101
TOWSON MD
21204-2600
US

IV. Provider business mailing address

901 DULANEY VALLEY RD DULANEY CENTER 2 SUITE101
TOWSON MD
21204-2600
US

V. Phone/Fax

Practice location:
  • Phone: 410-337-2707
  • Fax: 410-337-2841
Mailing address:
  • Phone: 410-337-2707
  • Fax: 410-337-2841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberD0008413
License Number StateMD

VIII. Authorized Official

Name: DR. RICHARD E LAYTON
Title or Position: DOCTOR
Credential: M.D.
Phone: 410-337-2707