Fantry, George T

Fantry, George T is an individual health care provider with primary practice located at 22 S Greene St , Baltimore MD 21201-1544. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Fantry, George T can be contacted via phone (410) 328-8732.

Contact Information

Primary practice address
22 S Greene St Baltimore MD 21201-1544
Fax: (410) 328-8315
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X D40061 Maryland

Profile Details

NPI number 1043272610
LBN Legal business name Fantry, George T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2006
Last updated Nov 12th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043272610 NPPES
Maryland Other 520626-02 & 01 BLUE CROSS/BLUE SHIELD
Maryland MEDICAID 1043272610 BLUE CROSS/BLUE SHIELD
Maryland MEDICAID 069451700 BLUE CROSS/BLUE SHIELD

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