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General NPI Number Information
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NPI Number | 1184142762
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Entity Type | Organization
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Legal Business Name | MARIETA S CARAGAY,M.D.
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Dates
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Enumeration Date | 09/05/2017
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Last Update Date | 09/05/2017
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Provider Practice Location Address
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Address Line | 3455 WILKENS AVE STE 102
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City | BALTIMORE
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State | MD
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Zip | 21229-5204
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Country | US
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Telephone | 410-355-2822
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Fax |
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Provider Business Mailing Address
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Address Line | 706 IVY HILL RD
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City | HUNT VALLEY
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State | MD
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Zip | 21030-1509
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Country | US
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Telephone | 410-336-9175
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MARIETA CARAGAY
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Credential |
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Telephone | 410-355-2822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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