NPIMap

Organization Active NPI

Patricia M Disharoon MD

  • Specialist
  • Baltimore, MD
National Provider Identifier
1780055343
Registry record updated Oct 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D22419 Issued in MD
Legal business name
PATRICIA M DISHAROON MD
Practice address
3414 Saint Paul St
Baltimore, MD 21218-2701
Phone
(410) 889-3060
Fax
(410) 243-8176
NPI assigned
Oct 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2015

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

Authorized official

Name
Ms. Ellen M Underwood
Title
Office Manager
Phone
(410) 889-3060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X D22419 MD Primary

Addresses

Primary practice location

3414 Saint Paul St
Baltimore, MD 21218-2701

Mailing address

3414 Saint Paul St
Baltimore, MD 21218-2701
Phone (410) 889-3060

National Provider Directory

National Provider Directory

Locations

3414 Saint Paul St
Baltimore, MD 21218
Phone (410) 323-7902

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1444262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444262400000",
    "number": "1780055343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 SAINT PAUL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182701",
            "telephone_number": "410-889-3060",
            "fax_number": "410-243-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 SAINT PAUL ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212182701",
            "telephone_number": "410-889-3060",
            "fax_number": "410-243-8176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICIA M DISHAROON MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-08",
        "last_updated": "2015-10-08",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "410-889-3060",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "D22419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; 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.