Provider Demographics
NPI:1407931959
Name:FINE, ERIC M (MD,MPH)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:M
Last Name:FINE
Suffix:
Gender:M
Credentials:MD,MPH
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:6401 YORK RD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-2152
Mailing Address - Country:US
Mailing Address - Phone:410-887-3422
Mailing Address - Fax:410-887-8473
Practice Address - Street 1:6401 YORK RD
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-2152
Practice Address - Country:US
Practice Address - Phone:410-887-3422
Practice Address - Fax:410-887-8473
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0001794208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF238Medicare UPIN