1184636680 NPI number — DAWN KOBRIN-MERRITTS M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184636680 NPI number — DAWN KOBRIN-MERRITTS M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

KOBRIN-MERRITTS

Provider First Name:

DAWN

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1184636680

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

07/09/2007

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

303 AIKEN TER

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

ABINGDON

Provider Business Mailing Address State Name:

MD

Provider Business Mailing Address Postal Code:

21009-2003

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

410-515-1628

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

9649 BELAIR RD

Provider Second Line Business Practice Location Address:

SECOND FLOOR

Provider Business Practice Location Address City Name:

BALTIMORE

Provider Business Practice Location Address State Name:

MD

Provider Business Practice Location Address Postal Code:

21236-1100

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

410-256-9340

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

08/13/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 208000000X , with the licence number:  D0035365 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 1974498 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 1974498 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
• Identifier: 93107 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
• Identifier: 0546322005 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 2331051 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
• Identifier: 039241 . This is a "JOHNS HOPKINS HEALTHCARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 281937 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
• Identifier: 35147703 . This is a "CAREFIRST BCBS MARYLAND" identifier . This identifiers is of the category "OTHER".
• Identifier: 9992 . This is a "KAISER" identifier . This identifiers is of the category "OTHER".
• Identifier: 110807 . This is a "COVENTRY" identifier . This identifiers is of the category "OTHER".
• Identifier: 700303 . This is a "NCPPO" identifier . This identifiers is of the category "OTHER".
• Identifier: 0010 . This is a "CAREFIRST DC" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 5841082 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".