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General NPI Number Information
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NPI Number | 1952915472
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Entity Type | Individual
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Provider Name | BERYL ACHIENG OTIENO MD
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Gender | Female
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Dates
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Enumeration Date | 09/02/2020
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 6565 N CHARLES ST STE 203
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City | TOWSON
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State | MD
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Zip | 21204-5805
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Country | US
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Telephone | 443-849-3760
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Fax | 443-849-8138
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Provider Business Mailing Address
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Address Line | 6201 GREENLEIGH AVE
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-2004
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Country | US
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Telephone | 410-933-6423
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Fax | 410-500-4266
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | D98374
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D98374
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License Number State | MD
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