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General NPI Number Information
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NPI Number | 1891965349
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Entity Type | Organization
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Legal Business Name | LERNER MD PA
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Dates
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Enumeration Date | 03/11/2008
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Last Update Date | 11/05/2010
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Provider Practice Location Address
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Address Line | 7434 HOLABIRD AVE
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City | BALTIMORE
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State | MD
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Zip | 21222-1829
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Country | US
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Telephone | 410-284-2273
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Fax | 410-284-2816
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Provider Business Mailing Address
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Address Line | 7434 HOLABIRD AVE
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City | BALTIMORE
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State | MD
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Zip | 21222-1829
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Country | US
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Telephone | 410-284-2273
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Fax | 410-284-2816
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRIAN C. LERNER
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Credential | M.D.
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Telephone | 410-284-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TA1982
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | D26533
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | D0022694
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License Number State | MD
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