Basic Information
| Provider Information | |||||||||
| NPI: | 1275914699 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAI | ||||||||
| FirstName: | SOPHIE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6201 GREENLEIGH AVE | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212202004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109336423 | ||||||||
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| Practice Location | |||||||||
| Address1: | 600 N WOLFE STREET | ||||||||
| Address2: | WILMER B20 | ||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212870005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109555650 | ||||||||
| FaxNumber: | 4106148496 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2015 | ||||||||
| LastUpdateDate: | 08/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | L-263967 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207W00000X | 2019-00606 | NC | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207WX0107X | 2019-00606 | NC | N | 207W00000X | D91503 | MD | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.