Basic Information
Provider Information
NPI: 1942257217
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABERNATHY
FirstName: JAMES
MiddleName: H
NamePrefix:  
NameSuffix: III
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9910 FRANKLIN SQUARE DR
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212364902
CountryCode: US
TelephoneNumber: 4109336423
FaxNumber: 4109331390
Practice Location
Address1: 1800 ORLEANS ST # 6208
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212870010
CountryCode: US
TelephoneNumber: 4109557519
FaxNumber: 4109550994
Other Information
ProviderEnumerationDate: 05/30/2006
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X28780SCN Allopathic & Osteopathic PhysiciansAnesthesiology 
207L00000XD84043MDY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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