Individual
DR. ANTHONY O EDOZIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 706-4613
(410) 706-4619
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 706-4613
(410) 706-4619
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
D62230
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4059522-00
BLUE CROSS/BLUE SHIELD
MD
05
—
405952200
—
MD
Enumeration date
05/06/2006
Last updated
05/15/2014
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