Individual
GAVIN TIMOTHY MCTAVISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1900 N HOWARD ST STE 300, BALTIMORE, MD 21218-5909
(443) 438-6742
Mailing address
714 E 37TH ST, BALTIMORE, MD 21218-2533
(240) 578-3446
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
28722
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28722
—
MD
Enumeration date
12/01/2022
Last updated
12/01/2022
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