Individual
TERRENCE THOMAS FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
516 GLENWOOD AVE, BALTIMORE, MD 21212-4230
(410) 925-1220
Mailing address
PO BOX 10445, BALTIMORE, MD 21209-0445
(410) 925-1220
(410) 601-0290
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
D31064
MD
207R00000X
Internal Medicine Physician
D31064
MD
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
D31064
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0497570
—
DC
05
—
465611300
—
MD
Enumeration date
10/16/2005
Last updated
03/21/2013
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