Provider Demographics
NPI:1467470344
Name:TREDINNICK, TODD J (MD)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:J
Last Name:TREDINNICK
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 1:201 PLUMTREE RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-6053
Mailing Address - Country:US
Mailing Address - Phone:410-569-3326
Mailing Address - Fax:410-569-3551
Practice Address - Street 1:201 PLUMTREE RD
Practice Address - Street 2:SUITE 301
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6053
Practice Address - Country:US
Practice Address - Phone:410-569-3326
Practice Address - Fax:410-569-3551
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0057576207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD680902200Medicaid
H24516Medicare UPIN
MDS783A993Medicare ID - Type Unspecified