Tyzack, Joanna Blake

Tyzack, Joanna Blake is an individual health care provider with primary practice located at 6535 N Charles St Ste 400, Baltimore MD 21204-5826. She recently has only one registered license in Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism, which is considered as her primary health care specialty. Tyzack, Joanna Blake can be contacted via phone (410) 828-7417.

Contact Information

Primary practice address
6535 N Charles St Ste 400 Baltimore MD 21204-5826
Phone: (410) 828-7417
Fax: (410) 828-0257
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Endocrinology, Diabetes & Metabolism 207RE0101X D42383 Maryland

Profile Details

NPI number 1487659892
LBN Legal business name Tyzack, Joanna Blake
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2005
Last updated Sep 29th, 2017 - about 8 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 1487659892 NPPES
Maryland MEDICAID 203561600

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