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NPI Code Detail

MEDICARE: DR. FIDELIS CAROLINE DEFINE MD

MEDICARE: DR. FIDELIS CAROLINE DEFINE MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RA0401XAddiction Medicine (Internal Medicine) PhysicianDOOO4251MD

General Provider Information

NPI Number : 1245474063
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FIDELIS CAROLINE DEFINE MD
Provider Business Mailing Address
First Line : 6701 N CHARLES ST
Second Line : 4104
City : TOWSON
State : MD
Zip : 21204-6808
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6701 N CHARLES ST
Second Line : 4104
City : TOWSON
State : MD
Zip : 21204-6808
Country : US
Telephone Number : 410-227-7149
Fax Number : 410-561-3911
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/23/2009
Last Update Date : 05/28/2009

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Directions to “ DR. FIDELIS CAROLINE DEFINE MD” Practice Location

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