Individual
PANAYIOTIS A. BALTATZIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8113 HARFORD RD, SUITE 100, BALTIMORE, MD 21234-5707
(410) 882-4800
(410) 882-6667
Mailing address
8113 HARFORD RD, SUITE 100, BALTIMORE, MD 21234-5707
(410) 882-4800
(410) 882-6667
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0028949
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010019494
RAILROAD MEDICARE
GA
01
—
199472YDHY
MEDICARE
MD
01
—
2110
MEDICARE
MD
01
—
359441600
MEDICAL ASSISTANCE
MD
Enumeration date
06/24/2006
Last updated
03/18/2011
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