Individual
KATHLEEN B TO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1590
(410) 328-9781
Mailing address
22 S GREENE ST # P1G01, BALTIMORE, MD 21201-1544
(410) 328-9781
(410) 328-3665
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
4301099480
MI
208600000X
Surgery Physician
A89279
CA
2086S0102X
Surgical Critical Care Physician
4301099480
MI
2086S0102X
Surgical Critical Care Physician
Primary
D0084004
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A89279
CA LICENSE
CA
Enumeration date
07/17/2007
Last updated
08/05/2024
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