Provider Demographics
NPI:1467622001
Name:JOSEPH B GIRLANDO DPM
Entity Type:Organization
Organization Name:JOSEPH B GIRLANDO DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:BLAISK
Authorized Official - Last Name:GIRLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:410-944-8805
Mailing Address - Street 1:7131 LIBERTY RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-4580
Mailing Address - Country:US
Mailing Address - Phone:410-944-8805
Mailing Address - Fax:410-944-2370
Practice Address - Street 1:7131 LIBERTY RD
Practice Address - Street 2:SUITE 104
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21207-4580
Practice Address - Country:US
Practice Address - Phone:410-944-8805
Practice Address - Fax:410-944-2370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00528213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4637780200Medicaid
MDT59813Medicare UPIN
MD4637780200Medicaid
MDT048Medicare PIN