NPIMap

Organization Active NPI

University of Maryland Dermatologists PA

  • Dermatology Physician
  • Lutherville, MD
National Provider Identifier
1770452633
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
UNIVERSITY OF MARYLAND DERMATOLOGISTS PA
Practice address
1447 York Rd Ste 102
Lutherville, MD 21093-6074
Phone
(667) 214-1171
NPI assigned
Oct 30, 2025
Last updated
Oct 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Katelyn Pettit
Title
Reimbursement Ops Credentialing Spe
Phone
(667) 214-1353

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

1447 York Rd Ste 102
Lutherville, MD 21093-6074

Mailing address

1447 York Rd Ste 102
Lutherville, MD 21093-6074
Phone (667) 214-1171

National Provider Directory

National Provider Directory
Tax ID family
University of Maryland Dermatologists PA8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1761782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761782400000",
    "number": "1770452633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1447 YORK RD STE 102",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936074",
            "telephone_number": "667-214-1171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1447 YORK RD STE 102",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210936074",
            "telephone_number": "667-214-1171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF MARYLAND DERMATOLOGISTS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-30",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A",
        "authorized_official_last_name": "PETTIT",
        "authorized_official_first_name": "KATELYN",
        "authorized_official_title_or_position": "REIMBURSEMENT OPS CREDENTIALING SPE",
        "authorized_official_telephone_number": "667-214-1353"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.