Provider Demographics
NPI:1174501381
Name:NAIMAN, JOHN BRUCE (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BRUCE
Last Name:NAIMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7850 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224
Mailing Address - Country:US
Mailing Address - Phone:410-282-4848
Mailing Address - Fax:410-282-4849
Practice Address - Street 1:7850 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224
Practice Address - Country:US
Practice Address - Phone:410-282-4848
Practice Address - Fax:410-282-4849
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-06
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0036470207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
0900109OtherUNITED HEALTH CARE
210952OtherMAMSI
1310134006OtherCIGNA
MD287961100Medicaid
E1060001OtherBLUE SHIELD FEDERAL
4069937OtherAETNA
MD40056001OtherCAREFIRST B S
4069937OtherAETNA
210952OtherMAMSI