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General NPI Number Information
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NPI Number | 1144161670
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Entity Type | Organization
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Legal Business Name | MIND BODY SOUL OBSTETRICS AND GYNECOLOGY
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Dates
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Enumeration Date | 04/01/2026
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Last Update Date | 04/01/2026
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Provider Practice Location Address
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Address Line | 1122 KENILWORTH DR STE 401
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City | TOWSON
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State | MD
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Zip | 21204-2147
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Country | US
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Telephone | 850-284-4338
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Fax |
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Provider Business Mailing Address
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Address Line | 9613 HARFORD RD STE C
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City | BALTIMORE
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State | MD
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Zip | 21234-2150
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Country | US
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Telephone | 850-284-4338
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ANALETA PETERSON
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Credential | MD
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Telephone | 850-284-4338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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