Provider Demographics
NPI:1922254002
Name:WARRICK, JOANN E (MD)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:E
Last Name:WARRICK
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 1:4940 EASTERN AVE STE P3-411
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-2735
Mailing Address - Country:US
Mailing Address - Phone:410-550-0886
Mailing Address - Fax:
Practice Address - Street 1:4940 EASTERN AVE STE P3-411
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2735
Practice Address - Country:US
Practice Address - Phone:410-550-0886
Practice Address - Fax:410-550-8161
Is Sole Proprietor?:No
Enumeration Date:2008-08-08
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD87665208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD87665OtherSTATE LICENSE
LA263616YTS0Medicare PIN
LA1043541Medicaid