MEDICARE: DR. NANCY KLEIN BAILOWITZ 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	D0047573	MD

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

General Provider Information

NPI Number	:	1922033117
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANCY KLEIN BAILOWITZ MD

Provider Business Mailing Address
First Line	:	3100 WYMAN PARK DR
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21211-2803
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2360 W JOPPA RD
Second Line	:	SUITE 306
City	:	LUTHERVILLE
State	:	MD
Zip	:	21093-4624
Country	:	US
Telephone Number	:	410-847-3535
Fax Number	:

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	05/09/2013

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