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Individual

G ROBERT MEDALIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6535 N CHARLES STREET, SUITE 325, BALTIMORE, MD 21204-5824
(410) 321-9701
(410) 321-0845
Mailing address
6535 N CHARLES STREET, SUITE 325, BALTIMORE, MD 21204-5824
(410) 321-9701
(410) 321-0845

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
D0021398
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060057954
RAILROAD MEDICARE
MD
05
138731600
MD
Enumeration date
08/03/2006
Last updated
04/28/2008
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