Provider Demographics
NPI:1184636680
Name:KOBRIN-MERRITTS, DAWN (MD)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:KOBRIN-MERRITTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 AIKEN TER
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-2003
Mailing Address - Country:US
Mailing Address - Phone:410-515-1628
Mailing Address - Fax:
Practice Address - Street 1:9649 BELAIR RD
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-1100
Practice Address - Country:US
Practice Address - Phone:410-256-9340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0035365208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
1974498OtherUNITED HEALTHCARE
MD1974498Medicaid
MD93107Medicaid
0546322005OtherCIGNA
2331051OtherAETNA HMO
039241OtherJOHNS HOPKINS HEALTHCARE
281937OtherMAMSI
35147703OtherCAREFIRST BCBS MARYLAND
9992OtherKAISER
110807OtherCOVENTRY
700303OtherNCPPO
MD0010OtherCAREFIRST DC
5841082OtherAETNA PPO
BB91Medicare ID - Type Unspecified
9992OtherKAISER