Individual
JONATHAN EKEDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 PARK AVE, BALTIMORE, MD 21201-3416
(410) 752-1677
(410) 752-4435
Mailing address
1227 HAUBERT ST, OPHTH: OPHTHALMOLOGY, BALTIMORE, MD 21230-5235
(301) 520-6887
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
D74366
MD
390200000X
Student in an Organized Health Care Education/Training Program
0116021210
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/30/2008
Last updated
10/04/2012
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