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Individual

DR. CAROLINE GERNELL DALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1040 PARK AVE, SUITE 200, BALTIMORE, MD 21201-5633
(443) 738-0300
(443) 738-0301
Mailing address
1040 PARK AVE, BALTIMORE, BALTIMORE, MD 21201-5633
(443) 738-0300
(443) 738-0301

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D0053063
MD
207R00000X
Internal Medicine Physician
Primary
T7190
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01970547
AMERIGROUP MCO
MD
05
132190100
MD
Enumeration date
08/16/2012
Last updated
12/15/2023
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