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General NPI Number Information
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NPI Number | 1972783926
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Entity Type | Organization
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Legal Business Name | SHASTINE ABATE MD PA
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Dates
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Enumeration Date | 11/07/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 7004 SECURITY BLVD STE 101
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City | BALTIMORE
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State | MD
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Zip | 21244-2557
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Country | US
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Telephone | 410-277-3490
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Fax | 410-277-4823
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Provider Business Mailing Address
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Address Line | 7004 SECURITY BLVD STE 101
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City | BALTIMORE
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State | MD
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Zip | 21244-2557
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Country | US
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Telephone | 410-277-3490
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Fax | 410-277-4823
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Authorized Official
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Title or Position | MD/PRESIDENT
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Name | SHASTINE ABATE
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Credential |
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Telephone | 410-277-3490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | D50296
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License Number State | MD
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