Provider Demographics
NPI:1447227137
Name:GRATZ & GUMBINAS, M.D., P.A.
Entity Type:Organization
Organization Name:GRATZ & GUMBINAS, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:GRATZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-601-8300
Mailing Address - Street 1:2435 W BELVEDERE AVE
Mailing Address - Street 2:SUITE 32
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5224
Mailing Address - Country:US
Mailing Address - Phone:410-601-8300
Mailing Address - Fax:410-601-8227
Practice Address - Street 1:2435 W BELVEDERE AVE
Practice Address - Street 2:SUITE 32
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5224
Practice Address - Country:US
Practice Address - Phone:410-601-8300
Practice Address - Fax:410-601-8227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-02
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD099281000Medicaid