Individual
BRENDAN B ANTIOCHOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-5624
(410) 550-7694
Mailing address
6201 GREENLEIGH AVE, BALTIMORE, MD 21220-2004
(410) 933-6423
(410) 500-4266
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD155471
OR
207RR0500X
Rheumatology Physician
Primary
D77846
MD
208M00000X
Hospitalist Physician
MD155471
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500639268
—
OR
Enumeration date
04/30/2008
Last updated
03/27/2025
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