1962604991 NPI number — DANIEL R. HOWARD, MD. PA

Table of content: (NPI 1962604991)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962604991 NPI number — DANIEL R. HOWARD, MD. PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DANIEL R. HOWARD, MD. PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

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 Information

NPI Number:
1962604991
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/15/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1714 EUTAW PL
Provider Second Line Business Mailing Address:
SUITE 2A
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21217-3730
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-779-9609
Provider Business Mailing Address Fax Number:
443-552-4758

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
405 N PACA ST
Provider Second Line Business Practice Location Address:
FIRST FLOOR
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21201-1815
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-779-9609
Provider Business Practice Location Address Fax Number:
443-552-4758
Provider Enumeration Date:
06/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HOWARD
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
RAY
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
410-779-9609

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  D0043386 , 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)

  • Identifier: 0H51DA . This is a "BCBS MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 413640300 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com