Individual
DR. ELYSE DARA PINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1111 N CHARLES ST, BALTIMORE, MD 21201-5505
(410) 837-2050
(410) 752-1374
Mailing address
1111 N CHARLES ST, BALTIMORE, MD 21201-5505
(410) 837-2050
(410) 752-1374
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D72266
MD
2080P0205X
Pediatric Endocrinology Physician
D72266
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
554414900
—
MD
Enumeration date
05/10/2007
Last updated
01/31/2022
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