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General NPI Number Information
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NPI Number | 1073755765
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Entity Type | Individual
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Provider Name | LUKASZ PAWEL GONDEK M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 04/03/2017
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Provider Practice Location Address
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Address Line | 1650 ORLEANS ST # 1-290
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City | BALTIMORE
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State | MD
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Zip | 21287-0013
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Country | US
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Telephone | 410-502-5847
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Fax |
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Provider Business Mailing Address
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Address Line | 1650 ORLEANS ST CRB1 ROOM 290
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City | BALTIMORE
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State | MD
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Zip | 21287-0013
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | D72150
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License Number State | MD
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