Allan Doctor, MD
Individual provider Active NPI Pediatric Critical Care Medicine Physician · Baltimore, MD
NPI 1659450484 · NPPES record last updated Jan 6, 2020
Key facts
- NPI
- 1659450484
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Critical Care Medicine Physician 2080P0203X
- License
- D88326 (MD)
- Practice address
- 22 S Greene St Ste G4K400
Baltimore, MD 21201-1544 - Phone
- (410) 328-6957
- Fax
- (410) 328-0680
- NPI assigned
- Nov 3, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Maryland Pediatric Associates, PA | Pediatrics | Current |
Accepting new patients |
| University of Maryland Pediatric Associates, PA | Pediatrics | Current |
Accepting new patients |
| University of Virginia Physicians Group | Past |
Accepting new patients |
Locations
22 S Greene St
Ste G4K400
Baltimore, MD 21201
Phone (410) 328-6957
22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793
12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Anesthesiology Physician | 207LP3000X | 2006031510 | MO | |
| Pediatrics Physician | 208000000X | 2006031510 | MO | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | 2006031510 | MO | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | D88326 | MD | Yes |
Addresses
Primary practice location
22 S Greene St Ste G4K400
Baltimore, MD 21201-1544
Mailing address
670 W Baltimore St
Baltimore, MD 21201-1519
Phone (410) 706-7088
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 204914402 | Medicaid | MO | |
| 502384000 | Medicaid | MD | |
| ENROLLED | Medicaid | IL |
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All providers in Baltimore, MD · Pediatric Critical Care Medicine Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.