Healthcare Provider Details

I. General information

NPI: 1528179850
Provider Name (Legal Business Name): ADELMO CRUZ MARANA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 OSLER DR SUITE 202
TOWSON MD
21204-7701
US

IV. Provider business mailing address

7600 OSLER DR SUITE 202
TOWSON MD
21204-7701
US

V. Phone/Fax

Practice location:
  • Phone: 410-821-7188
  • Fax: 410-821-7185
Mailing address:
  • Phone: 410-821-7188
  • Fax: 410-821-7185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberD20446
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: