=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386711810
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RONALD L. GINSBERG, MD, FACP, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/29/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19 WALKER AVE SUITE 302
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21208-4075
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-484-4840
-----------------------------------------------------
Fax | 410-484-1084
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19 WALKER AVE SUITE 302
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21208-4075
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 410-484-4840
-----------------------------------------------------
Fax | 410-484-1084
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. RONALD LAWRENCE GINSBERG
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 410-484-4840
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number | D14133
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------