1033572011 NPI number — KATELYN ANN URIBE MD

Table of content: KATELYN ANN URIBE MD (NPI 1033572011)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033572011 NPI number — KATELYN ANN URIBE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
URIBE
Provider First Name:
KATELYN
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COHEN
Provider Other First Name:
KATELYN
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1033572011
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/17/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 N CAROLINE STREET
Provider Second Line Business Mailing Address:
8TH FLOOR
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21231
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-997-0400
Provider Business Mailing Address Fax Number:
410-955-8248

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 N CAROLINE STREET
Provider Second Line Business Practice Location Address:
8TH FLOOR
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21231
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-997-0400
Provider Business Practice Location Address Fax Number:
410-955-8248
Provider Enumeration Date:
03/29/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  D88989 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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