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General NPI Number Information
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NPI Number | 1831919844
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Entity Type | Organization
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Legal Business Name | THE GOOD BOX BOUTIQUE
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Dates
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Enumeration Date | 10/14/2024
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 833 N HOWARD ST STE 2
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City | BALTIMORE
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State | MD
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Zip | 21201-4948
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Country | US
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Telephone | 347-885-2190
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Fax |
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Provider Business Mailing Address
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Address Line | 5521 GROVELAND AVE
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City | BALTIMORE
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State | MD
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Zip | 21215-4243
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Country | US
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Telephone | 347-885-2190
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHANNON THOMAS
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Credential |
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Telephone | 347-885-2190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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