Individual
JOHN T ANTONIADES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3449 WILKENS AVE STE 300, BALTIMORE, MD 21229
(667) 234-9992
(667) 234-9997
Mailing address
3449 WILKENS AVE STE 300, BALTIMORE, MD 21229-5218
(667) 234-9992
(667) 234-9997
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
D0058226
MD
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
D0058226
MD
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
D0058226
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405613200
—
MD
Enumeration date
06/30/2006
Last updated
05/02/2019
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