Individual
DR. GARY WILLIAM PUSHKIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2506 SAINT PAUL STREET, BALTIMORE, MD 21218
(410) 235-3300
(410) 366-1260
Mailing address
2506 SAINT PAUL STREET, BALTIMORE, MD 21218
(410) 235-3300
(410) 366-1260
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D0024470
MD
174400000X
Specialist
MD60569954
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
377641700
—
MD
Enumeration date
08/31/2005
Last updated
10/04/2018
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