Individual
DR. BENJAMIN BALTAZAR BANDONG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1501 DIVISION STREET, BALTIMORE, MD 21217
(410) 383-8300
(410) 728-4412
Mailing address
308 PATLEIGH ROAD, CATONSVILLE, MD 21228-5630
(410) 788-8875
(410) 747-4237
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0016938
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AB6155825
BHDD
—
01
—
D0016938
LICENSE
MD
Enumeration date
03/07/2006
Last updated
07/08/2007
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