Provider Demographics
NPI:1497044234
Name:KOLDOBSKIY, MICHAEL A (MD, PHD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:KOLDOBSKIY
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:9910 FRANKLIN SQUARE DR STE 2110
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4902
Mailing Address - Country:US
Mailing Address - Phone:410-933-6423
Mailing Address - Fax:410-933-1390
Practice Address - Street 1:600 N WOLFE ST
Practice Address - Street 2:CMSC 2-124
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-3224
Practice Address - Country:US
Practice Address - Phone:410-614-4493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2017-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD779932080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology