Organization
SHEPPARD PRATT PHYSICIANS, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BONNIE B. KATZ (VP CORPORATE BUSINESS DEVELOPMENT)
(410) 938-3150
Entity
Organization
Contact information
Practice address
6501 N CHARLES ST, BALTIMORE, MD 21204-6819
(410) 938-3150
(410) 938-3159
Mailing address
6501 N CHARLES ST, BALTIMORE, MD 21204-6819
(410) 938-3150
(410) 938-3159
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00Y734
MEDICARE PTAN
DC
01
—
374114
MAMSI COMMERCIAL INS #
MD
05
—
560801500
—
MD
01
—
814L
MEDICARE - SPEC LOCAITONS
MD
Enumeration date
07/09/2006
Last updated
01/27/2009
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