Individual
DR. ILEANA SHOWALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
301 SAINT PAUL PL, SUITE 612, BALTIMORE, MD 21202-2102
(410) 837-6126
(410) 539-3418
Mailing address
501 SAINT PAUL PL, APT. 1002, BALTIMORE, MD 21202-2270
(410) 837-8286
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D0061870
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405908500
—
MD
Enumeration date
10/17/2005
Last updated
12/08/2009
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