Provider Demographics
NPI:1720017478
Name:DRACHENBERG, CINTHIA I (MD)
Entity Type:Individual
Prefix:DR
First Name:CINTHIA
Middle Name:I
Last Name:DRACHENBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W PRATT ST STE 780
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-2470
Mailing Address - Country:US
Mailing Address - Phone:667-214-1608
Mailing Address - Fax:410-328-0929
Practice Address - Street 1:22 S GREENE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1544
Practice Address - Country:US
Practice Address - Phone:667-214-1608
Practice Address - Fax:410-328-0929
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2015-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0040130207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF41204Medicare UPIN
MDGL50Medicare PIN
MDCA9059Medicare PIN
MD220017402Medicare PIN