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General NPI Number Information
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NPI Number | 1811084395
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Entity Type | Organization
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Legal Business Name | ANTONIO A BERTUMEN MD PA
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 02/08/2008
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Provider Practice Location Address
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Address Line | 740 SOUTH CONKLING STREET
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City | BALTIMORE
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State | MD
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Zip | 21224
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Country | US
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Telephone | 410-732-7660
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Fax | 410-276-5080
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Provider Business Mailing Address
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Address Line | 740 SOUTH CONKLING STREET
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City | BALTIMORE
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State | MD
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Zip | 21224
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Country | US
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Telephone | 410-732-7660
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Fax | 410-276-5080
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANTONIO A BERTUMEN
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Credential | MD
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Telephone | 410-732-7660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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