Individual
ELLEN MARCINIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-1512
(410) 328-0177
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 328-1512
(410) 328-0177
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
57.013558
OH
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
D74874
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
494910200
—
MD
01
—
S062-0554
CAREFIRST BC/BS
MD
Enumeration date
08/09/2007
Last updated
09/22/2014
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