Provider Demographics
NPI:1508943408
Name:UNGURU, YORAM TAL (MD, MS, MA)
Entity Type:Individual
Prefix:DR
First Name:YORAM
Middle Name:TAL
Last Name:UNGURU
Suffix:
Gender:M
Credentials:MD, MS, MA
Other - Prefix:
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Mailing Address - Street 1:2401 W BELVEDERE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5216
Mailing Address - Country:US
Mailing Address - Phone:410-601-6704
Mailing Address - Fax:
Practice Address - Street 1:2401 W BELVEDERE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215
Practice Address - Country:US
Practice Address - Phone:410-601-5864
Practice Address - Fax:410-601-6027
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD0360472080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology