Provider Demographics
NPI:1083865018
Name:RICHARD E LAYTON MD PA
Entity Type:Organization
Organization Name:RICHARD E LAYTON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:LAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-337-2707
Mailing Address - Street 1:901 DULANEY VALLEY RD
Mailing Address - Street 2:DULANEY CENTER 2 SUITE101
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2600
Mailing Address - Country:US
Mailing Address - Phone:410-337-2707
Mailing Address - Fax:410-337-2841
Practice Address - Street 1:901 DULANEY VALLEY RD
Practice Address - Street 2:DULANEY CENTER 2 SUITE101
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2600
Practice Address - Country:US
Practice Address - Phone:410-337-2707
Practice Address - Fax:410-337-2841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0008413173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD78109Medicare UPIN
MDS913Medicare PIN