Provider Demographics
NPI:1356342778
Name:JOSEPH-HERBERT, JUDY (MD)
Entity type:Individual
Prefix:DR
First Name:JUDY
Middle Name:
Last Name:JOSEPH-HERBERT
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:PO BOX 64916
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4916
Mailing Address - Country:US
Mailing Address - Phone:443-481-6573
Mailing Address - Fax:443-481-6515
Practice Address - Street 1:2001 MEDICAL PKWY
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3280
Practice Address - Country:US
Practice Address - Phone:443-481-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2011-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00433712086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDCI4599P00115588OtherRR MEDICARE
MD269900101 048081900Medicaid
MDKJ86AN 546026-06OtherCAREFIRST BCBS
DCS3520016OtherCAREFIRST
MD52938006OtherCAREFIRST
V8140004OtherCAREFIRST
607156012OtherDEPT OF LABOR
V8140004OtherCAREFIRST
607156012OtherDEPT OF LABOR
MDF26785Medicare UPIN
MDP00917236Medicare PIN