Individual
MARK JOHN BASKERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5755 CEDAR LN, COLUMBIA, MD 21044-2912
(410) 884-8688
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-0000
(410) 500-4266
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
D54897
MD
207L00000X
Anesthesiology Physician
MD23614
OR
207P00000X
Emergency Medicine Physician
Primary
D0054897
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286886
—
OR
01
—
50086273
RAILROAD MEDICARE
OR
01
—
A048
TRICARE
OR
Enumeration date
04/18/2006
Last updated
03/09/2026
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