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General NPI Number Information
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NPI Number | 1235364001
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Entity Type | Organization
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Legal Business Name | FAITH ESTERSON MD LLC
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Dates
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Enumeration Date | 05/22/2009
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Last Update Date | 07/10/2009
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Provider Practice Location Address
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Address Line | 1838 GREENE TREE RD SUITE 340
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City | BALTIMORE
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State | MD
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Zip | 21208-6391
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Country | US
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Telephone | 410-602-3376
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Fax | 410-602-7954
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Provider Business Mailing Address
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Address Line | 914 MONAGHAN CT
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City | LUTHERVILLE
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State | MD
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Zip | 21093-1529
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Country | US
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Telephone | 410-616-9330
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Fax | 410-602-7954
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Authorized Official
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Title or Position | OWNER
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Name | DR. FAITH D ESTERSON
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Credential | M.D.
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Telephone | 410-602-3376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | D50904
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License Number State | MD
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