Organization
ANTONIADES ORTHOPAEDICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ANTONIADES MD (MD)
(410) 951-1773
Entity
Organization
Contact information
Practice address
3449 WILKENS AVE, STE 107, BALTIMORE, MD 21229-5281
(410) 368-9992
(410) 368-9997
Mailing address
25 BARTHEL CT, TIMONIUM, MD 21093-1528
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
873AAN
BC / BS OF MD
MD
01
—
J817
BLUECHOICE
MD
Enumeration date
06/23/2006
Last updated
10/22/2012
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