MEDICARE: DR. MICHAEL SERLIN 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
1	207R00000X	Internal Medicine Physician	222033	NY
2	207RI0200X	Infectious Disease Physician	222033	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0101256730	OTHER	VA	VIRGINIA LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568488336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL SERLIN MD

Provider Business Mailing Address
First Line	:	1040 PARK AVE STE 200
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21201-5634
Country	:	US
Telephone Number	:	443-738-0300
Fax Number	:	202-610-3095

Provider Business Practice Location Address
First Line	:	1040 PARK AVE STE 200
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21201-5634
Country	:	US
Telephone Number	:	443-738-0300
Fax Number	:	202-610-3095

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	05/31/2022

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Directions to “ DR. MICHAEL SERLIN MD” Practice Location

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