Individual
DR. CAROL IVY REYNOLDS-FREEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4 W ROLLING CROSSROADS, SUITE 100, BALTIMORE, MD 21228-6280
(410) 869-0100
(410) 869-0460
Mailing address
1829 REISTERSTOWN RD, SUITE 205, BALTIMORE, MD 21208-6320
(410) 602-9850
(410) 602-9857
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
D0027958
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
316481100
—
MH
01
—
X963
PROVIDER ID
MD
Enumeration date
10/31/2005
Last updated
12/23/2013
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