Provider Demographics
NPI:1811585003
Name:FRANKLIN, MAXIE III
Entity Type:Individual
Prefix:
First Name:MAXIE
Middle Name:
Last Name:FRANKLIN
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3416 BELAIR RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-1356
Mailing Address - Country:US
Mailing Address - Phone:410-488-9000
Mailing Address - Fax:443-449-7821
Practice Address - Street 1:3416 BELAIR RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-1356
Practice Address - Country:US
Practice Address - Phone:410-488-9000
Practice Address - Fax:443-449-7821
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-04
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)