Provider Demographics
NPI:1033177266
Name:GUREWITSCH ALLEN, EDITH D (MD)
Entity Type:Individual
Prefix:DR
First Name:EDITH
Middle Name:D
Last Name:GUREWITSCH ALLEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EDITH
Other - Middle Name:D
Other - Last Name:GUREWITSCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 64313
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4313
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:NELSON 2 OBSTETRICS PRACTICE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0005
Practice Address - Country:US
Practice Address - Phone:410-502-3148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2013-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD52071207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD840651100Medicaid
MD840651100Medicaid
MDG48993Medicare UPIN